- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $2,344.23 / $5,623.41
| Facility | | $363.08 | $2,344.23 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $1,548.82 / $4,897.79
| Facility | | $758.58 | $1,548.82 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $9,772.37 / $11,220.18
| Facility | | $6,309.57 | $9,772.37 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $891.25 / $16,218.10
| Facility | | $223.87 | $891.25 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $660.69 / $660.69 / $660.69
| Facility | 52 | $660.69 | $660.69 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,019.95 / $5,754.40
| Facility | | $2,137.96 | $3,019.95 | $5,754.40 |