- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,327.76 / $5,463.36 / $13,841.56
| Facility | | $2,327.76 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,070.46 / $5,901.02 / $10,355.91
| Facility | | $4,070.46 | $5,901.02 | $10,355.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $94.98 / $165.47 / $1,136.50
| Facility | | $94.98 | $165.47 | $1,136.50 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $6,012.68 / $6,012.68 / $6,012.68
| Facility | 52 | $6,012.68 | $6,012.68 | $6,012.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $184.88 / $257.55 / $2,516.35
| Facility | | $184.88 | $257.55 | $2,516.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |