- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $724.44 / $14,454.40
| Facility | | $457.09 | $724.44 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $18,197.01 / $30,902.95
| Facility | | $13,803.84 | $18,197.01 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $1,071.52 / $1,698.24
| Facility | | $912.01 | $1,071.52 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $7,413.10 / $14,454.40
| Facility | | $416.87 | $7,413.10 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $16,595.87 / $34,673.69
| Facility | | $407.38 | $16,595.87 | $34,673.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $851.14 / $1,513.56
| Professional | | $588.84 | $851.14 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51,286.14 / $51,286.14 / $75,857.76
| Facility | | $51,286.14 | $51,286.14 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $20,417.38 / $34,673.69
| Facility | | $8,709.64 | $20,417.38 | $34,673.69 |