- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $645.65 / $6,760.83
| Facility | | $645.65 | $645.65 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $13,803.84 / $32,359.37
| Facility | | $4,466.84 | $13,803.84 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $2,398.83 / $5,623.41
| Facility | | $1,698.24 | $2,398.83 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $2,290.87 / $4,466.84
| Facility | | $1,819.70 | $2,290.87 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $1,230.27 / $10,715.19
| Facility | | $660.69 | $1,230.27 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $6,309.57 / $13,182.57
| Facility | | $3,090.30 | $6,309.57 | $13,182.57 |