- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $543.78 / $5,909.48 / $13,841.56
| Facility | | $543.78 | $5,909.48 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,184.40 / $10,415.37 / $18,278.29
| Facility | | $7,184.40 | $10,415.37 | $18,278.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.76 / $416.92 / $824.80
| Facility | | $250.76 | $416.92 | $824.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.75 / $716.57 / $1,076.31
| Facility | | $478.75 | $716.57 | $1,076.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,528.46 / $3,093.00 / $7,934.00
| Facility | | $2,528.46 | $3,093.00 | $7,934.00 |