- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $6,025.60 / $9,332.54
| Facility | | $2,754.23 | $6,025.60 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,698.24 / $2,570.40 / $10,964.78
| Professional | | $1,698.24 | $2,570.40 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,479.11 / $2,754.23 / $4,466.84
| Professional | | $1,479.11 | $2,754.23 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $3,715.35
| Professional | | $32.36 | $33.11 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $23,442.29 / $52,480.75
| Facility | | $19,952.62 | $23,442.29 | $52,480.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,630.27 / $3,981.07 / $5,128.61
| Professional | | $2,630.27 | $3,981.07 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,778.28 / $3,801.89 / $5,011.87
| Professional | | $1,778.28 | $3,801.89 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,235.94 / $4,570.88
| Professional | | $2,137.96 | $3,235.94 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $5,128.61 / $15,848.93
| Facility | | $3,019.95 | $5,128.61 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,071.52 / $2,041.74 / $3,311.31
| Professional | | $1,071.52 | $2,041.74 | $3,311.31 |