- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $7,943.28 / $16,595.87
| Facility | | $660.69 | $7,943.28 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $7,079.46 / $13,182.57
| Facility | | $2,951.21 | $7,079.46 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $2,137.96 / $2,754.23
| Facility | | $707.95 | $2,137.96 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $758.58 / $1,174.90
| Facility | | $512.86 | $758.58 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $13,182.57 / $23,442.29
| Facility | | $5,128.61 | $13,182.57 | $23,442.29 |