- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $363.08 / $5,011.87
| Facility | | $363.08 | $363.08 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $13,803.84 / $41,686.94
| Facility | | $7,762.47 | $13,803.84 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $1,348.96 / $3,235.94
| Facility | | $954.99 | $1,348.96 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,288.25 / $2,511.89
| Facility | | $1,047.13 | $1,288.25 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $776.25 / $12,589.25
| Facility | | $457.09 | $776.25 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $8,709.64 / $15,135.61
| Facility | | $1,584.89 | $8,709.64 | $15,135.61 |