- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $6,025.60 / $8,709.64
| Facility | | $331.13 | $6,025.60 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $354.81 / $398.11
| Professional | | $223.87 | $354.81 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $44.67 / $60.26
| Professional | | $44.67 | $44.67 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $15,848.93 / $34,673.69
| Facility | | $13,489.63 | $15,848.93 | $34,673.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $467.74 / $512.86
| Professional | | $380.19 | $467.74 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $501.19 / $524.81
| Professional | | $426.58 | $501.19 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $5,128.61 / $24,547.09
| Facility | | $3,311.31 | $5,128.61 | $24,547.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $416.87 / $676.08
| Professional | | $323.59 | $416.87 | $676.08 |