- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $6,456.54 / $33,113.11
| Facility | | $794.33 | $6,456.54 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $18,620.87 / $29,512.09
| Facility | | $13,803.84 | $18,620.87 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,148.15 / $1,862.09
| Facility | | $1,000.00 | $1,148.15 | $1,862.09 |
- 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
- $645.65 / $933.25 / $1,659.59
| Professional | | $645.65 | $933.25 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97,723.72 / $97,723.72 / $141,253.75
| Facility | | $97,723.72 | $97,723.72 | $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 |