- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,513.56 / $14,454.40
| Facility | | $724.44 | $1,513.56 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,964.78 / $18,197.01
| Facility | | $6,606.93 | $10,964.78 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $2,238.72 / $3,801.89
| Facility | | $1,949.84 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $1,513.56 / $9,772.37
| Facility | | $741.31 | $1,513.56 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $1,698.24 / $15,135.61
| Facility | | $741.31 | $1,698.24 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,584.89 / $2,398.83
| Professional | | $1,047.13 | $1,584.89 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $11,220.18 / $16,595.87
| Facility | | $6,025.60 | $11,220.18 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $12,302.69 / $16,218.10
| Facility | | $7,585.78 | $12,302.69 | $16,218.10 |