- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $4,897.79 / $7,244.36
| Facility | | $346.74 | $4,897.79 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $18,197.01 / $26,302.68
| Facility | | $2,630.27 | $18,197.01 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $288.40 / $323.59
| Facility | | $275.42 | $288.40 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $467.74 / $575.44
| Facility | | $295.12 | $467.74 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $389.05 / $389.05 / $389.05
| Facility | 52 | $389.05 | $389.05 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $3,981.07 / $6,456.54
| Facility | | $1,412.54 | $3,981.07 | $6,456.54 |