- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,884.03 / $7,585.78
| Facility | | $724.44 | $2,884.03 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $2,454.71 / $4,677.35
| Facility | | $1,258.93 | $2,454.71 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $1,819.70 / $1,819.70
| Facility | | $199.53 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $1,148.15 / $1,445.44
| Facility | | $389.05 | $1,148.15 | $1,445.44 |
- 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
- $4,897.79 / $28,840.32 / $28,840.32
| Facility | | $4,897.79 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $3,890.45 / $3,890.45 / $3,890.45
| Facility | 52 | $3,890.45 | $3,890.45 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $354.81 / $2,454.71
| Facility | | $223.87 | $354.81 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $331.13 / $562.34
| Facility | | $218.78 | $331.13 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $2,511.89 / $4,786.30
| Facility | | $676.08 | $2,511.89 | $4,786.30 |