- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.99 / $3,090.30 / $5,623.41
| Facility | | $23.99 | $3,090.30 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.77 / $1,258.93 / $4,677.35
| Facility | | $46.77 | $1,258.93 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $2,290.87 / $2,290.87 / $2,290.87
| Facility | 52 | $2,290.87 | $2,290.87 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $478.63 / $954.99
| Facility | | $446.68 | $478.63 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.38 / $177.83 / $7,079.46
| Facility | | $21.38 | $177.83 | $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
- $46.77 / $1,258.93 / $4,677.35
| Facility | | $46.77 | $1,258.93 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $2,290.87 / $2,290.87 / $2,290.87
| Facility | 52 | $2,290.87 | $2,290.87 | $2,290.87 |
- 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 |