- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $1,659.59 / $4,466.84
| Facility | | $245.47 | $1,659.59 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $12,589.25 / $16,218.10
| Facility | | $5,754.40 | $12,589.25 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $3,981.07 / $6,456.54
| Facility | | $3,467.37 | $3,981.07 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $6,165.95 / $13,489.63
| Facility | | $245.47 | $6,165.95 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $7,943.28 / $16,595.87
| Facility | | $229.09 | $7,943.28 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $1,348.96 / $4,168.69
| Professional | | $436.52 | $1,348.96 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $9,549.93 / $52,480.75
| Facility | | $9,549.93 | $9,549.93 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $13,489.63 / $17,378.01
| Facility | | $8,912.51 | $13,489.63 | $17,378.01 |