- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $3,981.07 / $10,232.93
| Facility | | $1,047.13 | $3,981.07 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $186.21 / $741.31
| Professional | | $128.82 | $186.21 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $5,370.32 / $15,488.17
| Facility | | $2,691.53 | $5,370.32 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $138.04 / $302.00
| Professional | | $107.15 | $138.04 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $831.76 / $7,762.47
| Facility | | $416.87 | $831.76 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $316.23 / $891.25
| Professional | | $251.19 | $316.23 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $7,244.36 / $17,378.01
| Facility | | $2,398.83 | $7,244.36 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $239.88 / $457.09
| Professional | | $138.04 | $239.88 | $457.09 |