- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $3,467.37 / $16,218.10
| Facility | | $758.58 | $3,467.37 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $35,481.34 / $52,480.75
| Facility | | $4,570.88 | $35,481.34 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $691.83 / $776.25
| Facility | | $616.60 | $691.83 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $12,882.50 / $15,135.61
| Facility | | $12,882.50 | $12,882.50 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $13,182.57 / $20,417.38
| Facility | | $6,165.95 | $13,182.57 | $20,417.38 |