- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $5,623.41 / $14,454.40
| Facility | | $2,691.53 | $5,623.41 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,089.30 / $2,570.40 / $3,388.44
| Professional | | $2,089.30 | $2,570.40 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $5,011.87 / $15,488.17
| Facility | | $2,344.23 | $5,011.87 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.41 / $8.71 / $3,981.07
| Professional | | $7.41 | $8.71 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $5,248.07 / $13,803.84
| Facility | | $2,089.30 | $5,248.07 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,715.35 / $4,677.35 / $8,709.64
| Professional | | $3,715.35 | $4,677.35 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $3,235.94 / $3,801.89
| Facility | | $1,905.46 | $3,235.94 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,348.96 / $1,905.46 / $3,801.89
| Professional | | $1,348.96 | $1,905.46 | $3,801.89 |