- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $6,456.54 / $12,589.25
| Facility | | $338.84 | $6,456.54 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $8,317.64 / $10,964.78
| Facility | | $3,801.89 | $8,317.64 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $257.04 / $295.12
| Facility | | $251.19 | $257.04 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $398.11 / $549.54
| Facility | | $263.03 | $398.11 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $346.74 / $346.74 / $346.74
| Facility | 52 | $346.74 | $346.74 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $6,025.60 / $10,715.19
| Facility | | $2,137.96 | $6,025.60 | $10,715.19 |