- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $4,365.16 / $4,786.30
| Facility | | $128.82 | $4,365.16 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $3,630.78 / $8,709.64
| Facility | | $870.96 | $3,630.78 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $501.19 / $1,202.26
| Facility | | $316.23 | $501.19 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $190.55 / $190.55 / $190.55
| Facility | 52 | $190.55 | $190.55 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $489.78 / $954.99
| Facility | | $389.05 | $489.78 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $229.09 / $2,290.87
| Facility | | $141.25 | $229.09 | $2,290.87 |
- 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 |