- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $4,365.16 / $14,454.40
| Facility | | $2,691.53 | $4,365.16 | $14,454.40 |
- 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
- $5,495.41 / $6,309.57 / $10,232.93
| Facility | | $5,495.41 | $6,309.57 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $7,413.10 / $14,454.40
| Facility | | $2,511.89 | $7,413.10 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $3,801.89 / $9,549.93
| Facility | | $2,187.76 | $3,801.89 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,801.89 / $5,370.32 / $9,120.11
| Professional | | $3,801.89 | $5,370.32 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $5,495.41 / $52,480.75
| Facility | | $5,495.41 | $5,495.41 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $6,165.95 / $19,498.45
| Facility | | $2,290.87 | $6,165.95 | $19,498.45 |