- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,467.37 / $14,454.40
| Facility | | $2,137.96 | $3,467.37 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,964.78 / $18,197.01
| Facility | | $6,606.93 | $10,964.78 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $5,128.61 / $8,128.31
| Facility | | $4,365.16 | $5,128.61 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $7,244.36 / $13,489.63
| Facility | | $2,137.96 | $7,244.36 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $3,388.44 / $7,943.28
| Facility | | $1,862.09 | $3,388.44 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,019.95 / $4,265.80 / $7,244.36
| Professional | | $3,019.95 | $4,265.80 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $32,359.37 / $32,359.37
| Facility | | $4,365.16 | $32,359.37 | $32,359.37 |
- 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 |