- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,761.77 / $25,201.38 / $60,625.34
| Facility | | $17,761.77 | $25,201.38 | $60,625.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,153.08 / $3,547.62 / $28,968.86
| Professional | | $1,153.08 | $3,547.62 | $28,968.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,446.49 / $23,040.11 / $47,736.49
| Facility | | $14,446.49 | $23,040.11 | $47,736.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,091.98 / $6,692.60 / $24,588.77
| Professional | | $1,091.98 | $6,692.60 | $24,588.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $767.92 / $856.73 / $12,015.93
| Facility | | $767.92 | $856.73 | $12,015.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,578.44 / $28,868.39 / $28,868.39
| Professional | | $2,578.44 | $28,868.39 | $28,868.39 |