- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $5,623.41 / $13,182.57
| Facility | | $977.24 | $5,623.41 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $9,772.37 / $10,232.93
| Facility | | $1,148.15 | $9,772.37 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $25,703.96 / $25,703.96
| Facility | | $25,703.96 | $25,703.96 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $5,128.61 / $12,022.64
| Facility | | $549.54 | $5,128.61 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $6,165.95 / $11,748.98
| Facility | | $2,818.38 | $6,165.95 | $11,748.98 |