- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $4,897.79 / $14,125.38
| Facility | | $398.11 | $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
- $346.74 / $371.54 / $407.38
| Facility | | $346.74 | $371.54 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $588.84 / $977.24
| Facility | | $371.54 | $588.84 | $977.24 |
- 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 |