- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $229.09 / $2,630.27
| Facility | | $229.09 | $229.09 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $2,238.72 / $5,370.32
| Facility | | $602.56 | $2,238.72 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $891.25 / $2,089.30
| Facility | | $549.54 | $891.25 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $338.84 / $338.84 / $338.84
| Facility | 52 | $338.84 | $338.84 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $85.11 / $85.11 / $85.11
| Facility | 53 | $85.11 | $85.11 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $851.14 / $1,659.59
| Facility | | $676.08 | $851.14 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $407.38 / $2,290.87
| Facility | | $251.19 | $407.38 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $3,090.30 / $6,456.54
| Facility | | $1,230.27 | $3,090.30 | $6,456.54 |