- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $1,698.24 / $5,370.32
| Facility | | $446.68 | $1,698.24 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $30,902.95 / $45,708.82
| Facility | | $19,054.61 | $30,902.95 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $20,892.96 / $20,892.96
| Facility | | $39.81 | $20,892.96 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $724.44 / $724.44
| Facility | | $724.44 | $724.44 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $15,848.93 / $40,738.03
| Facility | | $1,621.81 | $15,848.93 | $40,738.03 |