- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $11,220.18 / $87,096.36
| Facility | | $575.44 | $11,220.18 | $87,096.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $4,786.30 / $9,332.54
| Facility | | $1,778.28 | $4,786.30 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $2,511.89 / $3,162.28
| Facility | | $2,511.89 | $2,511.89 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $338.84 / $741.31
| Facility | | $223.87 | $338.84 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $13,182.57 / $23,988.33
| Facility | | $5,128.61 | $13,182.57 | $23,988.33 |