- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $271.67 / $8,477.27 / $20,928.72
| Facility | | $271.67 | $8,477.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,766.83 / $15,476.59 / $29,936.73
| Facility | | $11,766.83 | $15,476.59 | $29,936.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $271.67 / $502.59 / $4,317.00
| Facility | | $271.67 | $502.59 | $4,317.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $361.61 / $698.69 / $979.21
| Facility | | $361.61 | $698.69 | $979.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,054.00 / $4,317.00 / $13,909.00
| Facility | | $3,054.00 | $4,317.00 | $13,909.00 |