- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $1,122.02 / $14,454.40
| Facility | | $602.56 | $1,122.02 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,897.79 / $7,585.78
| Facility | | $3,311.31 | $4,897.79 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,698.24 / $2,691.53
| Facility | | $1,445.44 | $1,698.24 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $1,584.89 / $4,265.80
| Facility | | $537.03 | $1,584.89 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $1,621.81 / $8,317.64
| Facility | | $575.44 | $1,621.81 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $851.14 / $1,174.90 / $1,819.70
| Professional | | $851.14 | $1,174.90 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $7,943.28 / $7,943.28
| Facility | | $5,370.32 | $7,943.28 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $7,413.10 / $9,120.11
| Facility | | $4,897.79 | $7,413.10 | $9,120.11 |