- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $4,073.80 / $15,135.61
| Facility | | $512.86 | $4,073.80 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,344.23 / $16,218.10
| Facility | | $724.44 | $2,344.23 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $13,803.84 / $15,848.93
| Facility | | $7,413.10 | $13,803.84 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $977.24 / $26,302.68
| Facility | | $416.87 | $977.24 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $2,818.38 / $5,248.07
| Facility | | $1,819.70 | $2,818.38 | $5,248.07 |