- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $14,791.08 / $67,608.30
| Facility | | $1,288.25 | $14,791.08 | $67,608.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141,253.75 / $154,881.66 / $169,824.37
| Facility | | $141,253.75 | $154,881.66 | $169,824.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.58 / $912.01 / $1,122.02
| Professional | | $758.58 | $912.01 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,445.44 / $2,137.96
| Professional | | $1,174.90 | $1,445.44 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,348.96 / $1,995.26
| Facility | | $891.25 | $1,348.96 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $1,230.27 / $39,810.72
| Facility | | $851.14 | $1,230.27 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,302.68 / $85,113.80 / $138,038.43
| Facility | | $26,302.68 | $85,113.80 | $138,038.43 |