- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,737.80 / $14,454.40
| Facility | | $933.25 | $1,737.80 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,964.78 / $18,197.01
| Facility | | $6,606.93 | $10,964.78 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $2,570.40 / $4,073.80
| Facility | | $2,187.76 | $2,570.40 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,122.02 / $7,943.28
| Facility | | $794.33 | $1,122.02 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $1,148.15 / $13,182.57
| Facility | | $812.83 | $1,148.15 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $954.99 / $1,698.24 / $2,630.27
| Professional | | $954.99 | $1,698.24 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $16,595.87 / $16,595.87
| Facility | | $11,220.18 | $16,595.87 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $12,302.69 / $16,218.10
| Facility | | $7,585.78 | $12,302.69 | $16,218.10 |