- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $577.62 / $8,477.27 / $20,928.72
| Facility | | $577.62 | $8,477.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,003.91 / $9,212.06 / $17,819.09
| Facility | | $7,003.91 | $9,212.06 | $17,819.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $577.62 / $1,017.04 / $3,755.90
| Facility | | $577.62 | $1,017.04 | $3,755.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $760.91 / $1,446.60 / $2,014.75
| Facility | | $760.91 | $1,446.60 | $2,014.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |