- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $562.34 / $2,630.27
| Facility | | $562.34 | $562.34 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $4,677.35 / $12,022.64
| Facility | | $2,511.89 | $4,677.35 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $2,041.74 / $4,897.79
| Facility | | $1,445.44 | $2,041.74 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $1,995.26 / $3,801.89
| Facility | | $1,584.89 | $1,995.26 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $1,071.52 / $3,981.07
| Facility | | $549.54 | $1,071.52 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $3,467.37 / $6,456.54
| Facility | | $1,380.38 | $3,467.37 | $6,456.54 |