- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $616.60 / $7,244.36
| Facility | | $616.60 | $616.60 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $5,754.40 / $13,182.57
| Facility | | $3,548.13 | $5,754.40 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,238.72 / $5,370.32
| Facility | | $1,584.89 | $2,238.72 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $2,137.96 / $4,168.69
| Facility | | $1,737.80 | $2,137.96 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $1,148.15 / $4,677.35
| Facility | | $562.34 | $1,148.15 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $3,715.35 / $7,079.46
| Facility | | $1,905.46 | $3,715.35 | $7,079.46 |