- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,318.26 / $2,570.40
| Facility | | $467.74 | $1,318.26 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $724.44 / $724.44 / $724.44
| Facility | 54 | $724.44 | $724.44 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $933.25 / $933.25
| Facility | | $933.25 | $933.25 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $954.99
| Facility | | $371.54 | $371.54 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $630.96 / $2,041.74
| Facility | | $269.15 | $630.96 | $2,041.74 |