- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $735.38 / $8,369.76 / $30,593.00
| Facility | | $735.38 | $8,369.76 | $30,593.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $600.12 / $859.31 / $978.21
| Professional | | $600.12 | $859.31 | $978.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $372.65 / $755.29 / $1,109.49
| Facility | | $372.65 | $755.29 | $1,109.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $533.89 / $731.06 / $778.60
| Facility | | $533.89 | $731.06 | $778.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $516.04 / $918.54 / $1,109.49
| Facility | | $516.04 | $918.54 | $1,109.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62,246.10 / $77,972.48 / $94,895.79
| Facility | | $62,246.10 | $77,972.48 | $94,895.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,425.00 / $64,404.00 / $94,117.00
| Facility | | $7,425.00 | $64,404.00 | $94,117.00 |