- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $535.24 / $535.24 / $5,151.85
| Facility | | $535.24 | $535.24 | $5,151.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,412.52 / $5,939.08 / $11,503.06
| Facility | | $2,412.52 | $5,939.08 | $11,503.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,308.20 / $1,856.15 / $4,465.22
| Facility | | $1,308.20 | $1,856.15 | $4,465.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,189.28 / $1,696.97 / $3,515.93
| Facility | | $1,189.28 | $1,696.97 | $3,515.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $539.11 / $1,039.32 / $5,499.00
| Facility | | $539.11 | $1,039.32 | $5,499.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,121.00 / $5,499.00 / $9,810.00
| Facility | | $3,121.00 | $5,499.00 | $9,810.00 |