- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.55 / $3,353.10 / $10,817.26
| Facility | | $501.55 | $3,353.10 | $10,817.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,614.00 / $7,572.00 / $18,942.00
| Facility | | $1,614.00 | $7,572.00 | $18,942.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $474.16 / $604.32 / $750.21
| Facility | | $474.16 | $604.32 | $750.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,623.15 / $2,623.15 / $2,623.15
| Facility | | $2,623.15 | $2,623.15 | $2,623.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,932.00 / $8,025.00 / $11,038.00
| Facility | | $3,932.00 | $8,025.00 | $11,038.00 |