- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $676.08 / $5,011.87
| Facility | | $676.08 | $676.08 | $5,011.87 |
- 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
- $1,737.80 / $2,454.71 / $5,888.44
| Facility | | $1,737.80 | $2,454.71 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $2,344.23 / $4,570.88
| Facility | | $1,905.46 | $2,344.23 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $1,258.93 / $3,981.07
| Facility | | $660.69 | $1,258.93 | $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 |