- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $389.05 / $2,630.27
| Facility | | $389.05 | $389.05 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $6,456.54 / $14,791.08
| Facility | | $2,344.23 | $6,456.54 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,445.44 / $3,467.37
| Facility | | $1,023.29 | $1,445.44 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,412.54 / $2,754.23
| Facility | | $1,122.02 | $1,412.54 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $794.33 / $6,760.83
| Facility | | $407.38 | $794.33 | $6,760.83 |
- 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 |