- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $1,202.26 / $14,454.40
| Facility | | $562.34 | $1,202.26 | $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
- $1,513.56 / $1,778.28 / $2,951.21
| Facility | | $1,513.56 | $1,778.28 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $1,148.15 / $3,981.07
| Facility | | $562.34 | $1,148.15 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $1,202.26 / $8,317.64
| Facility | | $588.84 | $1,202.26 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $870.96 / $1,318.26 / $1,995.26
| Professional | | $870.96 | $1,318.26 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $6,025.60 / $8,912.51
| Facility | | $3,235.94 | $6,025.60 | $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 |