- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,445.44 / $14,454.40
| Facility | | $676.08 | $1,445.44 | $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
- $1,819.70 / $2,137.96 / $3,548.13
| Facility | | $1,819.70 | $2,137.96 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,380.38 / $6,918.31
| Facility | | $676.08 | $1,380.38 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,445.44 / $15,135.61
| Facility | | $691.83 | $1,445.44 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,584.89 / $2,398.83
| Professional | | $1,047.13 | $1,584.89 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $13,489.63 / $19,952.62
| Facility | | $7,244.36 | $13,489.63 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $12,302.69 / $16,595.87
| Facility | | $7,585.78 | $12,302.69 | $16,595.87 |