- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $691.83 / $7,079.46
| Facility | | $691.83 | $691.83 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $24,547.09 / $58,884.37
| Facility | | $4,168.69 | $24,547.09 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $2,511.89 / $6,025.60
| Facility | | $1,778.28 | $2,511.89 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $2,398.83 / $4,786.30
| Facility | | $1,949.84 | $2,398.83 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,348.96 / $10,715.19
| Facility | | $691.83 | $1,348.96 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $9,120.11 / $13,182.57
| Facility | | $4,365.16 | $9,120.11 | $13,182.57 |