- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $2,238.72 / $3,715.35
| Facility | | $363.08 | $2,238.72 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $1,949.84 / $19,498.45
| Facility | | $363.08 | $1,949.84 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $199.53 / $218.78 / $549.54
| Facility | 53 | $199.53 | $218.78 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $223.87 / $512.86
| Facility | | $223.87 | $223.87 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $870.96 / $1,995.26
| Facility | | $446.68 | $870.96 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $380.19 / $7,079.46
| Facility | | $144.54 | $380.19 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $3,162.28 / $8,511.38
| Facility | | $616.60 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $1,778.28 / $2,454.71
| Facility | | $1,659.59 | $1,778.28 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $1,949.84 / $19,498.45
| Facility | | $363.08 | $1,949.84 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $199.53 / $218.78 / $549.54
| Facility | 53 | $199.53 | $218.78 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $2,691.53 / $8,511.38
| Facility | | $676.08 | $2,691.53 | $8,511.38 |