- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $3,467.37 / $4,897.79
| Facility | | $302.00 | $3,467.37 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $25,703.96 / $32,359.37
| Facility | | $9,772.37 | $25,703.96 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $204.17 / $229.09
| Facility | | $194.98 | $204.17 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $338.84 / $446.68
| Facility | | $213.80 | $338.84 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $5,754.40 / $12,022.64
| Facility | | $1,412.54 | $5,754.40 | $12,022.64 |