- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $3,981.07 / $8,511.38
| Facility | | $575.44 | $3,981.07 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $5,248.07 / $57,543.99
| Facility | | $5,011.87 | $5,248.07 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $831.76 / $5,128.61
| Facility | | $489.78 | $831.76 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $436.52 / $436.52 / $436.52
| Facility | 52 | $436.52 | $436.52 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $107.15 / $107.15 / $107.15
| Facility | 53 | $107.15 | $107.15 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $630.96 / $630.96
| Facility | | $630.96 | $630.96 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $9,332.54 / $28,840.32
| Facility | | $3,090.30 | $9,332.54 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $3,311.31 / $8,511.38
| Facility | | $616.60 | $3,311.31 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $524.81 / $645.65
| Facility | | $426.58 | $524.81 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $416.87 / $446.68
| Facility | | $309.03 | $416.87 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $2,951.21 / $11,220.18
| Facility | | $851.14 | $2,951.21 | $11,220.18 |