- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $851.14 / $14,454.40
| Facility | | $398.11 | $851.14 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $15,135.61 / $26,302.68
| Facility | | $7,585.78 | $15,135.61 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,230.27 / $2,089.30
| Facility | | $1,047.13 | $1,230.27 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $851.14 / $5,495.41
| Facility | | $407.38 | $851.14 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $912.01 / $11,481.54
| Facility | | $426.58 | $912.01 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $1,000.00 / $1,548.82
| Professional | | $660.69 | $1,000.00 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $13,489.63 / $19,952.62
| Facility | | $7,244.36 | $13,489.63 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,232.93 / $14,454.40
| Facility | | $6,606.93 | $10,232.93 | $14,454.40 |