- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $794.33 / $5,011.87
| Facility | | $794.33 | $794.33 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $8,912.51 / $17,378.01
| Facility | | $4,073.80 | $8,912.51 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $2,754.23 / $6,606.93
| Facility | | $1,949.84 | $2,754.23 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $2,630.27 / $5,128.61
| Facility | | $2,137.96 | $2,630.27 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,348.96 / $6,918.31
| Facility | | $794.33 | $1,348.96 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $6,025.60 / $10,715.19
| Facility | | $3,019.95 | $6,025.60 | $10,715.19 |