- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $2,630.27 / $6,760.83
| Facility | | $1,047.13 | $2,630.27 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $870.96 / $1,862.09
| Professional | | $316.23 | $870.96 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $6,606.93 / $10,715.19
| Facility | | $4,168.69 | $6,606.93 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $512.86 / $1,862.09
| Professional | | $346.74 | $512.86 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $2,344.23 / $7,244.36
| Facility | | $446.68 | $2,344.23 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,621.81 / $10,471.29
| Professional | | $1,148.15 | $1,621.81 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $4,265.80 / $8,128.31
| Facility | | $1,230.27 | $4,265.80 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $933.25 / $1,737.80
| Professional | | $288.40 | $933.25 | $1,737.80 |