- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $4,897.79 / $10,232.93
| Facility | | $436.52 | $4,897.79 | $10,232.93 |
- 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
- $295.12 / $354.81 / $436.52
| Professional | | $295.12 | $354.81 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $812.83 / $812.83 / $812.83
| Professional | | $812.83 | $812.83 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $478.63 / $776.25
| Facility | | $338.84 | $478.63 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $489.78 / $10,964.78
| Facility | | $323.59 | $489.78 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $24,547.09 / $138,038.43
| Facility | | $5,623.41 | $24,547.09 | $138,038.43 |