- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $2,818.38 / $8,511.38
| Facility | | $812.83 | $2,818.38 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,715.19 / $11,220.18
| Facility | | $6,606.93 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $912.01 / $1,258.93
| Facility | | $741.31 | $912.01 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,445.44 / $1,445.44
| Facility | | $34.67 | $1,445.44 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,148.15 / $1,148.15 / $1,148.15
| Facility | 52 | $1,148.15 | $1,148.15 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $4,168.69 / $30,199.52
| Facility | | $407.38 | $4,168.69 | $30,199.52 |