- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $562.34 / $562.34
| Facility | | $371.54 | $562.34 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $7,585.78 / $22,908.68
| Facility | | $4,365.16 | $7,585.78 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $2,041.74 / $4,786.30
| Facility | | $1,445.44 | $2,041.74 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $1,949.84 / $3,801.89
| Facility | | $1,548.82 | $1,949.84 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $741.31 / $2,238.72
| Facility | | $436.52 | $741.31 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $4,786.30 / $8,912.51
| Facility | | $2,398.83 | $4,786.30 | $8,912.51 |