- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $3,801.89 / $14,791.08
| Facility | | $467.74 | $3,801.89 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $52,480.75 / $54,954.09
| Facility | | $43,651.58 | $52,480.75 | $54,954.09 |
- 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
- $870.96 / $870.96 / $870.96
| Professional | | $870.96 | $870.96 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $524.81 / $812.83
| Facility | | $363.08 | $524.81 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $501.19 / $30,199.52
| Facility | | $346.74 | $501.19 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $37,153.52 / $61,659.50
| Facility | | $10,964.78 | $37,153.52 | $61,659.50 |