- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.70 / $128.29 / $3,245.80
| Facility | | $67.70 | $128.29 | $3,245.80 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $33.85 / $64.15 / $64.15
| Facility | 52 | $33.85 | $64.15 | $64.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.98 / $53.84 / $1,253.53
| Facility | | $0.98 | $53.84 | $1,253.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $299.85 / $425.22 / $1,022.92
| Facility | | $299.85 | $425.22 | $1,022.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $243.75 / $388.75 / $805.45
| Facility | | $243.75 | $388.75 | $805.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.47 / $216.81 / $2,203.42
| Facility | | $110.47 | $216.81 | $2,203.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,063.00 / $1,597.44 / $3,584.00
| Facility | | $1,063.00 | $1,597.44 | $3,584.00 |