- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $7,244.36 / $16,595.87
| Facility | | $630.96 | $7,244.36 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $5,888.44 / $10,232.93
| Facility | | $2,398.83 | $5,888.44 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $3,090.30 / $3,981.07
| Facility | | $501.19 | $3,090.30 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $331.13 / $616.60
| Facility | | $229.09 | $331.13 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $13,182.57 / $23,988.33
| Facility | | $5,128.61 | $13,182.57 | $23,988.33 |