- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $3,630.78 / $9,549.93
| Facility | | $436.52 | $3,630.78 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $26,915.35 / $37,153.52
| Facility | | $15,135.61 | $26,915.35 | $37,153.52 |
- 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
- $831.76 / $831.76 / $831.76
| Professional | | $831.76 | $831.76 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $478.63 / $794.33
| Facility | | $338.84 | $478.63 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $489.78 / $7,413.10
| Facility | | $331.13 | $489.78 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,467.37 / $7,079.46
| Facility | | $1,698.24 | $3,467.37 | $7,079.46 |