- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $6,760.83 / $17,378.01
| Facility | | $512.86 | $6,760.83 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $14,791.08 / $15,848.93
| Facility | | $11,748.98 | $14,791.08 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $380.19 / $467.74
| Professional | | $316.23 | $380.19 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $645.65 / $851.14
| Professional | | $512.86 | $645.65 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $549.54 / $812.83
| Facility | | $363.08 | $549.54 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $512.86 / $14,125.38
| Facility | | $338.84 | $512.86 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $12,882.50 / $29,512.09
| Facility | | $7,762.47 | $12,882.50 | $29,512.09 |