- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $724.44 / $7,762.47
| Facility | | $724.44 | $724.44 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $7,585.78 / $15,848.93
| Facility | | $4,265.80 | $7,585.78 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $2,630.27 / $6,309.57
| Facility | | $1,862.09 | $2,630.27 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $2,511.89 / $5,011.87
| Facility | | $2,041.74 | $2,511.89 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $1,445.44 / $6,760.83
| Facility | | $741.31 | $1,445.44 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $4,786.30 / $8,912.51
| Facility | | $2,398.83 | $4,786.30 | $8,912.51 |