- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $645.65 / $4,466.84
| Facility | | $645.65 | $645.65 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $6,025.60 / $13,182.57
| Facility | | $3,801.89 | $6,025.60 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $2,344.23 / $5,623.41
| Facility | | $1,659.59 | $2,344.23 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $2,290.87 / $4,365.16
| Facility | | $1,819.70 | $2,290.87 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,318.26 / $7,762.47
| Facility | | $691.83 | $1,318.26 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $5,370.32 / $8,912.51
| Facility | | $1,584.89 | $5,370.32 | $8,912.51 |