- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $630.96 / $6,760.83
| Facility | | $630.96 | $630.96 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $11,748.98 / $26,915.35
| Facility | | $3,388.44 | $11,748.98 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,238.72 / $5,248.07
| Facility | | $1,548.82 | $2,238.72 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $2,137.96 / $4,168.69
| Facility | | $1,698.24 | $2,137.96 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,230.27 / $10,964.78
| Facility | | $676.08 | $1,230.27 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $9,120.11 / $14,791.08
| Facility | | $4,466.84 | $9,120.11 | $14,791.08 |