- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,318.26 / $14,454.40
| Facility | | $630.96 | $1,318.26 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $15,135.61 / $26,302.68
| Facility | | $10,715.19 | $15,135.61 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $1,949.84 / $3,090.30
| Facility | | $1,659.59 | $1,949.84 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $1,318.26 / $6,456.54
| Facility | | $645.65 | $1,318.26 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $1,380.38 / $11,481.54
| Facility | | $660.69 | $1,380.38 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $954.99 / $1,445.44 / $2,187.76
| Professional | | $954.99 | $1,445.44 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $19,952.62 / $19,952.62
| Facility | | $13,489.63 | $19,952.62 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,232.93 / $14,454.40
| Facility | | $6,606.93 | $10,232.93 | $14,454.40 |