- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $5,128.61 / $69,183.10
| Facility | | $549.54 | $5,128.61 | $69,183.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141,253.75 / $154,881.66 / $169,824.37
| Facility | | $141,253.75 | $154,881.66 | $169,824.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $389.05 / $478.63
| Professional | | $323.59 | $389.05 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $912.01 / $912.01 / $912.01
| Professional | | $912.01 | $912.01 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $537.03 / $851.14
| Facility | | $371.54 | $537.03 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $524.81 / $39,810.72
| Facility | | $363.08 | $524.81 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,547.09 / $85,113.80 / $138,038.43
| Facility | | $24,547.09 | $85,113.80 | $138,038.43 |