- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,818.38 / $8,511.38
| Facility | | $660.69 | $2,818.38 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $10,715.19 / $15,135.61
| Facility | | $8,912.51 | $10,715.19 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $891.25 / $1,047.13
| Facility | | $630.96 | $891.25 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,202.26 / $1,202.26
| Facility | | $34.67 | $1,202.26 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $4,466.84 / $30,199.52
| Facility | | $602.56 | $4,466.84 | $30,199.52 |