- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $3,548.13 / $9,772.37
| Facility | | $1,096.48 | $3,548.13 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $812.83 / $2,818.38 / $10,715.19
| Professional | | $812.83 | $2,818.38 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $4,466.84 / $12,882.50
| Facility | | $2,570.40 | $4,466.84 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $162.18 / $467.74
| Professional | | $123.03 | $162.18 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,118.72 / $50,118.72 / $53,703.18
| Facility | | $50,118.72 | $50,118.72 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $1,202.26 / $3,630.78
| Facility | | $295.12 | $1,202.26 | $3,630.78 |