- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $2,630.27
| Facility | | $512.86 | $512.86 | $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
- $1,318.26 / $1,905.46 / $4,466.84
| Facility | | $1,318.26 | $1,905.46 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,819.70 / $3,548.13
| Facility | | $1,445.44 | $1,819.70 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $977.24 / $3,890.45
| Facility | | $512.86 | $977.24 | $3,890.45 |
- 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 |