- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $2,754.23 / $12,022.64
| Facility | | $602.56 | $2,754.23 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,548.82 / $2,290.87
| Facility | | $1,148.15 | $1,548.82 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $27,542.29 / $33,884.42
| Facility | | $22,908.68 | $27,542.29 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $616.60 / $20,892.96
| Facility | | $363.08 | $616.60 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $549.54 / $33,884.42
| Facility | | $380.19 | $549.54 | $33,884.42 |