- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.30 / $26.92 / $7,762.47
| Facility | | $26.30 | $26.92 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $2,344.23 / $3,890.45
| Facility | | $1,071.52 | $2,344.23 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $32.36
| Facility | | $32.36 | $32.36 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $26.30 / $26.30 / $26.30
| Facility | 52 | $26.30 | $26.30 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.62 / $30.20 / $54.95
| Facility | | $18.62 | $30.20 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $3,467.37 / $5,011.87
| Facility | | $562.34 | $3,467.37 | $5,011.87 |