- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $1,258.93 / $9,772.37
| Facility | | $512.86 | $1,258.93 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $1,230.27 / $1,230.27 / $1,348.96
| Facility | 54 | $1,230.27 | $1,230.27 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $512.86 / $977.24
| Professional | | $407.38 | $512.86 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $407.38 / $645.65
| Professional | | $269.15 | $407.38 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $1,122.02 / $2,398.83
| Facility | | $562.34 | $1,122.02 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $602.56 / $870.96
| Professional | | $478.63 | $602.56 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $575.44 / $1,380.38
| Facility | | $371.54 | $575.44 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $537.03 / $537.03 / $537.03
| Facility | 54 | $537.03 | $537.03 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $602.56 / $1,023.29
| Professional | | $489.78 | $602.56 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $794.33 / $794.33 / $1,148.15
| Professional | | $794.33 | $794.33 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $630.96 / $1,071.52
| Facility | | $457.09 | $630.96 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $3,890.45 / $7,762.47
| Facility | | $1,096.48 | $3,890.45 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $478.63 / $776.25
| Professional | | $371.54 | $478.63 | $776.25 |