- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $371.54 / $2,137.96
| Facility | | $66.07 | $371.54 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $1,445.44 / $52,480.75
| Facility | | $380.19 | $1,445.44 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $123.03 / $177.83
| Facility | | $123.03 | $123.03 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $24.55 / $24.55 / $24.55
| Facility | 53 | $24.55 | $24.55 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.70 / $131.83 / $288.40
| Facility | | $53.70 | $131.83 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $2,344.23 / $4,073.80
| Facility | | $416.87 | $2,344.23 | $4,073.80 |