- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $9,120.11 / $53,703.18
| Facility | | $2,137.96 | $9,120.11 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,513.56 / $1,778.28 / $3,715.35
| Professional | | $1,513.56 | $1,778.28 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,348.96 / $2,187.76 / $3,162.28
| Professional | | $1,348.96 | $2,187.76 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,570.40 / $3,981.07
| Professional | | $1,513.56 | $2,570.40 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $2,398.83 / $4,466.84
| Facility | | $1,621.81 | $2,398.83 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $6,760.83 / $9,120.11
| Facility | | $2,454.71 | $6,760.83 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,511.89 / $3,890.45
| Professional | | $1,584.89 | $2,511.89 | $3,890.45 |