- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $4,897.79 / $7,244.36
| Facility | | $933.25 | $4,897.79 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $40,738.03 / $57,543.99
| Facility | | $16,982.44 | $40,738.03 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $758.58 / $851.14
| Facility | | $676.08 | $758.58 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $977.24 / $1,584.89
| Facility | | $724.44 | $977.24 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $11,481.54 / $17,782.79
| Facility | | $5,011.87 | $11,481.54 | $17,782.79 |