- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $812.83 / $2,630.27
| Facility | | $812.83 | $812.83 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $12,882.50 / $29,512.09
| Facility | | $4,786.30 | $12,882.50 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $2,951.21 / $6,918.31
| Facility | | $2,041.74 | $2,951.21 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $2,818.38 / $5,495.41
| Facility | | $2,238.72 | $2,818.38 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $1,621.81 / $8,709.64
| Facility | | $831.76 | $1,621.81 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $5,248.07 / $16,595.87
| Facility | | $2,884.03 | $5,248.07 | $16,595.87 |