- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $2,089.30 / $3,715.35
| Facility | | $131.83 | $2,089.30 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $1,122.02 / $3,548.13
| Facility | | $162.18 | $1,122.02 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $169.82 / $169.82 / $169.82
| Facility | 53 | $169.82 | $169.82 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.71 / $104.71 / $245.47
| Facility | | $104.71 | $104.71 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $676.08 / $741.31
| Facility | | $275.42 | $676.08 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $177.83 / $7,079.46
| Facility | | $56.23 | $177.83 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $1,949.84 / $7,079.46
| Facility | | $346.74 | $1,949.84 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $912.01 / $4,786.30
| Facility | | $158.49 | $912.01 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $1,122.02 / $3,548.13
| Facility | | $162.18 | $1,122.02 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $169.82 / $169.82 / $169.82
| Facility | 53 | $169.82 | $169.82 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $2,041.74 / $5,623.41
| Facility | | $467.74 | $2,041.74 | $5,623.41 |