- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.11 / $3,630.78 / $8,511.38
| Facility | | $33.11 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,677.35 / $8,912.51
| Facility | | $2,238.72 | $4,677.35 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $1,659.59 / $1,659.59
| Facility | | $1,659.59 | $1,659.59 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.20 / $30.90 / $2,290.87
| Facility | | $18.20 | $30.90 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $38.90 / $2,187.76 / $2,187.76
| Facility | 52 | $38.90 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,258.93 / $2,951.21
| Facility | | $724.44 | $1,258.93 | $2,951.21 |