- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $1,023.29 / $3,090.30
| Facility | | $478.63 | $1,023.29 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $3,801.89 / $8,128.31
| Facility | | $1,548.82 | $3,801.89 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $1,949.84 / $4,677.35
| Facility | | $1,380.38 | $1,949.84 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $562.34 / $562.34 / $562.34
| Facility | 54 | $562.34 | $562.34 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $1,862.09 / $3,630.78
| Facility | | $1,513.56 | $1,862.09 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $891.25 / $1,737.80
| Facility | | $478.63 | $891.25 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $1,862.09 / $4,168.69
| Facility | | $602.56 | $1,862.09 | $4,168.69 |