- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $4,897.79 / $7,244.36
| Facility | | $204.17 | $4,897.79 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $18,197.01 / $26,302.68
| Facility | | $2,630.27 | $18,197.01 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $186.21 / $208.93
| Facility | | $177.83 | $186.21 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $758.58 / $5,370.32
| Facility | | $323.59 | $758.58 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $7,762.47 / $10,964.78
| Facility | | $3,235.94 | $7,762.47 | $10,964.78 |