- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $776.25 / $14,454.40
| Facility | | $478.63 | $776.25 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $18,620.87 / $30,902.95
| Facility | | $13,803.84 | $18,620.87 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,148.15 / $1,819.70
| Facility | | $977.24 | $1,148.15 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $7,413.10 / $14,454.40
| Facility | | $446.68 | $7,413.10 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $23,442.29 / $81,283.05
| Facility | | $436.52 | $23,442.29 | $81,283.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $912.01 / $1,621.81
| Professional | | $630.96 | $912.01 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95,499.26 / $95,499.26 / $141,253.75
| Facility | | $95,499.26 | $95,499.26 | $141,253.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $25,118.86 / $85,113.80
| Facility | | $14,125.38 | $25,118.86 | $85,113.80 |