- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $2,137.96 / $8,317.64
| Facility | | $1,047.13 | $2,137.96 | $8,317.64 |
- 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
- $5,011.87 / $5,754.40 / $9,332.54
| Facility | | $5,011.87 | $5,754.40 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $2,089.30 / $5,754.40
| Facility | | $1,047.13 | $2,089.30 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $2,137.96 / $13,182.57
| Facility | | $1,047.13 | $2,137.96 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,905.46 / $3,388.44 / $5,888.44
| Professional | | $1,905.46 | $3,388.44 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $14,791.08 / $21,877.62
| Facility | | $7,943.28 | $14,791.08 | $21,877.62 |
- 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 |