- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $9,549.93 / $16,218.10
| Facility | | $776.25 | $9,549.93 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $18,197.01 / $26,302.68
| Facility | | $4,570.88 | $18,197.01 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $537.03 / $616.60
| Facility | | $524.81 | $537.03 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $870.96 / $1,148.15
| Facility | | $575.44 | $870.96 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $9,549.93 / $16,218.10
| Facility | | $4,265.80 | $9,549.93 | $16,218.10 |