- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,884.03 / $5,128.61
| Facility | | $1,513.56 | $2,884.03 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,344.23 / $10,715.19
| Facility | | $56.23 | $2,344.23 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $19,054.61 / $19,054.61 / $19,054.61
| Facility | 52 | $19,054.61 | $19,054.61 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $741.31 / $9,332.54
| Facility | | $676.08 | $741.31 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $416.87 / $8,511.38
| Facility | | $257.04 | $416.87 | $8,511.38 |
- 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
- $2,089.30 / $2,089.30 / $2,089.30
| Facility | | $2,089.30 | $2,089.30 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,344.23 / $10,715.19
| Facility | | $56.23 | $2,344.23 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $19,054.61 / $19,054.61 / $19,054.61
| Facility | 52 | $19,054.61 | $19,054.61 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $3,548.13 / $10,715.19
| Facility | | $676.08 | $3,548.13 | $10,715.19 |