- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $2,089.30 / $3,715.35
| Facility | | $112.20 | $2,089.30 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $512.86 / $2,818.38
| Facility | | $56.23 | $512.86 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $407.38 / $407.38 / $407.38
| Facility | 54 | $407.38 | $407.38 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $112.20 / $257.04
| Facility | | $112.20 | $112.20 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $50.12 / $50.12
| Facility | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.33 / $218.78 / $7,079.46
| Facility | | $102.33 | $218.78 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $112.20 / $602.56
| Facility | | $112.20 | $112.20 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $512.86 / $2,818.38
| Facility | | $56.23 | $512.86 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $407.38 / $407.38 / $407.38
| Facility | 54 | $407.38 | $407.38 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,819.70 / $2,818.38
| Facility | | $501.19 | $1,819.70 | $2,818.38 |