- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $4,897.79 / $14,125.38
| Facility | | $173.78 | $4,897.79 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $41,686.94 / $57,543.99
| Facility | | $23,988.33 | $41,686.94 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $162.18 / $173.78
| Facility | | $147.91 | $162.18 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $263.03 / $537.03
| Facility | | $165.96 | $263.03 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $11,220.18 / $17,378.01
| Facility | | $5,128.61 | $11,220.18 | $17,378.01 |