- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $891.25 / $6,760.83
| Facility | | $891.25 | $891.25 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $29,512.09 / $70,794.58
| Facility | | $5,011.87 | $29,512.09 | $70,794.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $3,090.30 / $7,413.10
| Facility | | $2,187.76 | $3,090.30 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $2,951.21 / $5,888.44
| Facility | | $2,398.83 | $2,951.21 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $1,584.89 / $9,772.37
| Facility | | $954.99 | $1,584.89 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $9,120.11 / $35,481.34
| Facility | | $4,466.84 | $9,120.11 | $35,481.34 |