- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $7,413.10 / $10,715.19
| Facility | | $724.44 | $7,413.10 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $24,547.09 / $31,622.78
| Facility | | $7,413.10 | $24,547.09 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $575.44 / $676.08
| Facility | | $489.78 | $575.44 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $812.83 / $1,174.90
| Facility | | $512.86 | $812.83 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $11,220.18 / $17,378.01
| Facility | | $4,897.79 | $11,220.18 | $17,378.01 |