- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $588.84 / $616.60
| Facility | | $524.81 | $588.84 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $3,981.07 / $11,481.54
| Facility | | $2,511.89 | $3,981.07 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,137.96 / $5,128.61
| Facility | | $1,513.56 | $2,137.96 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $794.33 / $794.33 / $794.33
| Facility | 52 | $794.33 | $794.33 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $691.83 / $691.83 / $691.83
| Facility | 54 | $691.83 | $691.83 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $2,041.74 / $3,981.07
| Facility | | $1,621.81 | $2,041.74 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $1,148.15 / $3,981.07
| Facility | | $588.84 | $1,148.15 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $3,467.37 / $6,456.54
| Facility | | $1,380.38 | $3,467.37 | $6,456.54 |