- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $6,606.93
| Facility | | $512.86 | $512.86 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $11,748.98 / $26,915.35
| Facility | | $3,235.94 | $11,748.98 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,995.26 / $4,677.35
| Facility | | $1,230.27 | $1,995.26 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $1,905.46 / $3,715.35
| Facility | | $1,513.56 | $1,905.46 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $870.96 / $5,623.41
| Facility | | $524.81 | $870.96 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $7,943.28 / $12,589.25
| Facility | | $2,951.21 | $7,943.28 | $12,589.25 |