- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $4,466.84 / $36,307.81
| Facility | | $2,137.96 | $4,466.84 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $14,454.40 / $20,892.96
| Facility | | $10,715.19 | $14,454.40 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $14,125.38 / $15,848.93
| Facility | | $14,125.38 | $14,125.38 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $512.86 / $20,417.38
| Professional | | $323.59 | $512.86 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $13,489.63 / $13,489.63
| Facility | | $13,489.63 | $13,489.63 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $20,892.96 / $34,673.69
| Facility | | $4,786.30 | $20,892.96 | $34,673.69 |