- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $363.08 / $3,981.07
| Facility | | $363.08 | $363.08 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $11,481.54 / $26,915.35
| Facility | | $2,398.83 | $11,481.54 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $1,380.38 / $3,311.31
| Facility | | $870.96 | $1,380.38 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,318.26 / $2,630.27
| Facility | | $1,071.52 | $1,318.26 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $588.84 / $1,621.81
| Facility | | $380.19 | $588.84 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $3,548.13 / $9,332.54
| Facility | | $1,513.56 | $3,548.13 | $9,332.54 |