- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $6,760.83 / $13,803.84
| Facility | | $398.11 | $6,760.83 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $10,964.78 / $25,703.96
| Facility | | $2,238.72 | $10,964.78 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $21,877.62 / $52,480.75
| Facility | | $15,135.61 | $21,877.62 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $20,892.96 / $40,738.03
| Facility | | $16,982.44 | $20,892.96 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $7,762.47 / $15,488.17
| Facility | | $602.56 | $7,762.47 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $11,220.18 / $22,908.68
| Facility | | $5,623.41 | $11,220.18 | $22,908.68 |