- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $288.40 / $3,467.37
| Facility | | $147.91 | $288.40 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $3,311.31 / $7,943.28
| Facility | | $870.96 | $3,311.31 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $1,023.29 / $2,454.71
| Facility | | $645.65 | $1,023.29 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $199.53 / $199.53 / $199.53
| Facility | 52 | $199.53 | $199.53 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $977.24 / $1,905.46
| Facility | | $794.33 | $977.24 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $489.78 / $3,981.07
| Facility | | $218.78 | $489.78 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,548.13 / $6,456.54
| Facility | | $1,584.89 | $3,548.13 | $6,456.54 |