- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $5,248.07 / $12,302.69
| Facility | | $1,380.38 | $5,248.07 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $912.01 / $1,174.90 / $2,818.38
| Professional | | $912.01 | $1,174.90 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $7,413.10 / $15,135.61
| Facility | | $2,884.03 | $7,413.10 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $933.25 / $1,318.26 / $2,630.27
| Professional | | $933.25 | $1,318.26 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $1,995.26 / $7,762.47
| Facility | | $398.11 | $1,995.26 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,548.82 / $3,467.37
| Professional | | $1,023.29 | $1,548.82 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $8,912.51 / $19,054.61
| Facility | | $2,884.03 | $8,912.51 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $891.25 / $1,258.93 / $2,398.83
| Professional | | $891.25 | $1,258.93 | $2,398.83 |