- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $8,511.38 / $14,454.40
| Facility | | $7,244.36 | $8,511.38 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,584.89 / $1,584.89 / $7,943.28
| Professional | | $1,584.89 | $1,584.89 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $7,762.47 / $15,135.61
| Facility | | $6,025.60 | $7,762.47 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $1,778.28 / $6,165.95
| Facility | | $870.96 | $1,778.28 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $1,819.70 / $6,309.57
| Facility | | $870.96 | $1,819.70 | $6,309.57 |