- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $1,380.38 / $8,128.31
| Facility | | $123.03 | $1,380.38 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $8,317.64 / $10,471.29
| Facility | | $2,344.23 | $8,317.64 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.33 / $104.71 / $120.23
| Facility | | $102.33 | $104.71 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $181.97 / $1,862.09
| Facility | | $181.97 | $181.97 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $144.54 / $144.54 / $144.54
| Facility | 52 | $144.54 | $144.54 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $3,715.35 / $6,456.54
| Facility | | $1,412.54 | $3,715.35 | $6,456.54 |