- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $3,090.30 / $6,760.83
| Facility | | $1,318.26 | $3,090.30 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $1,096.48 / $1,995.26
| Facility | | $416.87 | $1,096.48 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $4,677.35 / $7,762.47
| Facility | | $3,548.13 | $4,677.35 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $371.54 / $2,454.71
| Facility | | $263.03 | $371.54 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $588.84 / $18,197.01 / $18,197.01
| Facility | 52 | $588.84 | $18,197.01 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $2,089.30 / $5,128.61
| Facility | | $977.24 | $2,089.30 | $5,128.61 |