- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $3,715.35 / $10,471.29
| Facility | | $616.60 | $3,715.35 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,548.82 / $2,454.71
| Facility | | $1,148.15 | $1,548.82 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $27,542.29 / $33,884.42
| Facility | | $22,908.68 | $27,542.29 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $2,454.71 / $16,218.10
| Facility | | $346.74 | $2,454.71 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $4,265.80 / $6,606.93
| Facility | | $1,862.09 | $4,265.80 | $6,606.93 |