- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $1,023.29 / $14,454.40
| Facility | | $478.63 | $1,023.29 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $7,943.28 / $12,589.25
| Facility | | $5,011.87 | $7,943.28 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,513.56 / $2,454.71
| Facility | | $1,318.26 | $1,513.56 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $954.99 / $5,495.41
| Facility | | $478.63 | $954.99 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,023.29 / $8,317.64
| Facility | | $501.19 | $1,023.29 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $741.31 / $1,122.02 / $1,737.80
| Professional | | $741.31 | $1,122.02 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $8,912.51 / $8,912.51
| Facility | | $6,025.60 | $8,912.51 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $7,413.10 / $9,120.11
| Facility | | $4,897.79 | $7,413.10 | $9,120.11 |