- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $1,949.84 / $13,803.84
| Facility | | $1,513.56 | $1,949.84 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.44 / $1,621.81 / $1,995.26
| Professional | | $724.44 | $1,621.81 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,479.11 / $8,912.51
| Facility | | $1,023.29 | $1,479.11 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,513.56 / $1,548.82
| Facility | | $1,148.15 | $1,513.56 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $1,288.25 / $1,995.26
| Facility | | $912.01 | $1,288.25 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $10,232.93 / $12,302.69
| Facility | | $7,762.47 | $10,232.93 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $12,882.50 / $26,302.68
| Facility | | $2,137.96 | $12,882.50 | $26,302.68 |