- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $5,495.41 / $11,748.98
| Facility | | $3,162.28 | $5,495.41 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,862.09 / $2,398.83
| Professional | | $1,318.26 | $1,862.09 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $33,113.11 / $69,183.10
| Facility | | $18,197.01 | $33,113.11 | $69,183.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,905.46 / $2,511.89 / $3,630.78
| Professional | | $1,905.46 | $2,511.89 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,481.34 / $46,773.51 / $67,608.30
| Facility | | $35,481.34 | $46,773.51 | $67,608.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,778.28 / $2,511.89 / $4,073.80
| Professional | | $1,778.28 | $2,511.89 | $4,073.80 |