- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,413.61 / $5,215.93 / $9,868.40
| Facility | | $3,413.61 | $5,215.93 | $9,868.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,807.00 / $17,284.09 / $24,194.30
| Facility | | $7,807.00 | $17,284.09 | $24,194.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.00 / $610.00 / $3,340.46
| Facility | | $490.00 | $610.00 | $3,340.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,805.96 / $3,386.48 / $5,001.07
| Professional | | $2,805.96 | $3,386.48 | $5,001.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,839.46 / $3,741.97 / $5,583.17
| Facility | | $2,839.46 | $3,741.97 | $5,583.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,445.38 / $3,601.91 / $6,454.84
| Facility | | $2,445.38 | $3,601.91 | $6,454.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $327.00 / $2,397.00 / $5,202.00
| Facility | | $327.00 | $2,397.00 | $5,202.00 |