- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $7,244.36 / $16,595.87
| Facility | | $977.24 | $7,244.36 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $4,365.16 / $8,128.31
| Facility | | $1,819.70 | $4,365.16 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $2,137.96 / $2,754.23
| Facility | | $501.19 | $2,137.96 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $501.19 / $851.14
| Facility | | $354.81 | $501.19 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $11,220.18 / $16,982.44
| Facility | | $2,754.23 | $11,220.18 | $16,982.44 |