- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $8,912.51 / $22,387.21
| Facility | | $3,715.35 | $8,912.51 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $10,715.19 / $17,782.79
| Facility | | $6,025.60 | $10,715.19 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $4,786.30 / $13,182.57
| Facility | | $66.07 | $4,786.30 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $21,379.62 / $28,840.32
| Facility | | $6,918.31 | $21,379.62 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $724.44 / $977.24
| Professional | | $562.34 | $724.44 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $776.25 / $1,258.93
| Professional | | $588.84 | $776.25 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $33,884.42 / $33,884.42
| Facility | | $19,952.62 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $870.96 / $1,380.38
| Facility | | $660.69 | $870.96 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $12,302.69 / $26,915.35
| Facility | | $6,760.83 | $12,302.69 | $26,915.35 |