- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $7,762.47 / $14,791.08
| Facility | | $4,570.88 | $7,762.47 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $61.66 / $354.81
| Professional | | $47.86 | $61.66 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $17,378.01 / $31,622.78
| Facility | | $8,912.51 | $17,378.01 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $794.33 / $977.24
| Professional | | $275.42 | $794.33 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $12,589.25 / $21,877.62
| Facility | | $8,912.51 | $12,589.25 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $91.20 / $776.25
| Professional | | $54.95 | $91.20 | $776.25 |