- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $6,918.31 / $10,715.19
| Facility | | $2,137.96 | $6,918.31 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,479.11 / $2,089.30
| Professional | | $1,230.27 | $1,479.11 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $13,182.57 / $22,908.68
| Facility | | $7,943.28 | $13,182.57 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,698.24 / $2,187.76 / $3,162.28
| Professional | | $1,698.24 | $2,187.76 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $9,120.11 / $19,498.45
| Facility | | $8,317.64 | $9,120.11 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,023.29 / $1,288.25
| Professional | | $1,023.29 | $1,023.29 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $2,570.40 / $6,606.93
| Facility | | $1,071.52 | $2,570.40 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,290.87 / $3,311.31
| Professional | | $1,513.56 | $2,290.87 | $3,311.31 |