- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $2,630.27
| Facility | | $512.86 | $512.86 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $11,481.54 / $26,915.35
| Facility | | $1,288.25 | $11,481.54 | $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
- $537.03 / $912.01 / $2,754.23
| Facility | | $537.03 | $912.01 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $5,248.07 / $9,332.54
| Facility | | $1,445.44 | $5,248.07 | $9,332.54 |