- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $3,467.37 / $4,897.79
| Facility | | $977.24 | $3,467.37 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $14,454.40 / $19,498.45
| Facility | | $6,456.54 | $14,454.40 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $660.69 / $741.31
| Facility | | $602.56 | $660.69 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,047.13 / $1,778.28
| Facility | | $724.44 | $1,047.13 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $13,803.84 / $20,417.38
| Facility | | $6,165.95 | $13,803.84 | $20,417.38 |