- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $3,715.35 / $6,760.83
| Facility | | $213.80 | $3,715.35 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $3,801.89 / $8,709.64
| Facility | | $1,862.09 | $3,801.89 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $831.76 / $1,949.84
| Facility | | $512.86 | $831.76 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $309.03 / $309.03 / $309.03
| Facility | 52 | $309.03 | $309.03 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $794.33 / $1,548.82
| Facility | | $630.96 | $794.33 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $436.52 / $2,754.23
| Facility | | $239.88 | $436.52 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $3,467.37 / $6,456.54
| Facility | | $1,445.44 | $3,467.37 | $6,456.54 |