- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $8,511.38 / $27,542.29
| Facility | | $851.14 | $8,511.38 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $25,118.86 / $31,622.78
| Facility | | $4,570.88 | $25,118.86 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $741.31 / $851.14
| Facility | | $724.44 | $741.31 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $3,801.89 / $3,801.89
| Facility | | $3,801.89 | $3,801.89 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $11,220.18 / $17,378.01
| Facility | | $4,897.79 | $11,220.18 | $17,378.01 |