- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $537.03 / $3,981.07
| Facility | | $398.11 | $537.03 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $5,888.44 / $12,589.25
| Facility | | $2,454.71 | $5,888.44 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,089.30 / $5,011.87
| Facility | | $1,318.26 | $2,089.30 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $1,995.26 / $3,890.45
| Facility | | $1,621.81 | $1,995.26 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $691.83 / $1,584.89
| Facility | | $354.81 | $691.83 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $4,786.30 / $8,912.51
| Facility | | $1,659.59 | $4,786.30 | $8,912.51 |