- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $389.05 / $2,454.71
| Facility | | $389.05 | $389.05 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,128.61 / $10,715.19
| Facility | | $2,137.96 | $5,128.61 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $1,380.38 / $3,235.94
| Facility | | $954.99 | $1,380.38 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,318.26 / $2,570.40
| Facility | | $1,047.13 | $1,318.26 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $676.08 / $5,623.41
| Facility | | $371.54 | $676.08 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $5,248.07 / $8,912.51
| Facility | | $2,884.03 | $5,248.07 | $8,912.51 |