- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.36 / $5,370.32 / $7,943.28
| Facility | | $32.36 | $5,370.32 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,202.26 / $1,202.26
| Facility | | $1,202.26 | $1,202.26 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.20 / $46.77 / $128.82
| Professional | | $18.20 | $46.77 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.91 / $48.98 / $2,884.03
| Facility | | $22.91 | $48.98 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $2,187.76 / $2,187.76 / $2,187.76
| Facility | 52 | $2,187.76 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.69 / $46.77 / $54.95
| Professional | | $41.69 | $46.77 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,202.26 / $1,202.26
| Facility | | $1,202.26 | $1,202.26 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $3,162.28 / $6,309.57
| Facility | | $1,412.54 | $3,162.28 | $6,309.57 |