- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $812.83 / $7,079.46
| Facility | | $812.83 | $812.83 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $11,481.54 / $22,387.21
| Facility | | $5,248.07 | $11,481.54 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $3,235.94 / $7,585.78
| Facility | | $2,290.87 | $3,235.94 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $3,090.30 / $6,025.60
| Facility | | $2,454.71 | $3,090.30 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,548.82 / $6,760.83
| Facility | | $1,096.48 | $1,548.82 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $4,677.35 / $8,912.51
| Facility | | $1,288.25 | $4,677.35 | $8,912.51 |