- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,479.11 / $14,454.40
| Facility | | $707.95 | $1,479.11 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,897.79 / $7,585.78
| Facility | | $3,311.31 | $4,897.79 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $2,187.76 / $3,548.13
| Facility | | $1,905.46 | $2,187.76 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,479.11 / $10,232.93
| Facility | | $707.95 | $1,479.11 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,548.82 / $8,317.64
| Facility | | $724.44 | $1,548.82 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,548.82 / $2,344.23
| Professional | | $1,023.29 | $1,548.82 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $5,370.32 / $7,943.28
| Facility | | $2,884.03 | $5,370.32 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $7,413.10 / $9,120.11
| Facility | | $4,897.79 | $7,413.10 | $9,120.11 |