- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $4,897.79 / $8,511.38
| Facility | | $977.24 | $4,897.79 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $10,715.19 / $11,220.18
| Facility | | $6,456.54 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,318.26 / $1,548.82
| Facility | | $933.25 | $1,318.26 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,778.28 / $1,778.28
| Facility | | $34.67 | $1,778.28 | $1,778.28 |
- 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 |