- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $1,258.93 / $14,454.40
| Facility | | $588.84 | $1,258.93 | $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
- $1,584.89 / $1,862.09 / $3,090.30
| Facility | | $1,584.89 | $1,862.09 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $1,202.26 / $5,495.41
| Facility | | $588.84 | $1,202.26 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $1,258.93 / $11,481.54
| Facility | | $602.56 | $1,258.93 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $912.01 / $1,380.38 / $2,089.30
| Professional | | $912.01 | $1,380.38 | $2,089.30 |
- 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
- $6,606.93 / $10,232.93 / $14,454.40
| Facility | | $6,606.93 | $10,232.93 | $14,454.40 |