- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $3,311.31 / $11,220.18
| Facility | | $912.01 | $3,311.31 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $28,183.83 / $39,810.72
| Facility | | $4,168.69 | $28,183.83 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $660.69 / $741.31
| Facility | | $588.84 | $660.69 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $4,677.35 / $5,623.41
| Facility | | $4,677.35 | $4,677.35 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $9,549.93 / $16,218.10
| Facility | | $4,466.84 | $9,549.93 | $16,218.10 |