- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $33,113.11 / $79,432.82
| Facility | | $22,908.68 | $33,113.11 | $79,432.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,479.11 / $13,803.84 / $36,307.81
| Professional | | $1,479.11 | $13,803.84 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $31,622.78 / $63,095.73
| Facility | | $25,703.96 | $31,622.78 | $63,095.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,380.38 / $8,317.64 / $32,359.37
| Professional | | $1,380.38 | $8,317.64 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $12,022.64 / $26,915.35
| Facility | | $1,096.48 | $12,022.64 | $26,915.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11,481.54 / $19,498.45 / $43,651.58
| Professional | | $11,481.54 | $19,498.45 | $43,651.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $954.99 / $8,128.31 / $32,359.37
| Professional | | $954.99 | $8,128.31 | $32,359.37 |