- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $1,380.38 / $14,454.40
| Facility | | $660.69 | $1,380.38 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $15,488.17 / $26,302.68
| Facility | | $11,481.54 | $15,488.17 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $2,041.74 / $3,311.31
| Facility | | $1,778.28 | $2,041.74 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,318.26 / $5,495.41
| Facility | | $676.08 | $1,318.26 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,380.38 / $15,135.61
| Facility | | $676.08 | $1,380.38 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $977.24 / $1,513.56 / $2,290.87
| Professional | | $977.24 | $1,513.56 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $27,542.29 / $27,542.29
| Facility | | $18,620.87 | $27,542.29 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $13,803.84 / $17,782.79
| Facility | | $8,912.51 | $13,803.84 | $17,782.79 |