- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $676.08 / $14,454.40
| Facility | | $371.54 | $676.08 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,317.64 / $13,182.57
| Facility | | $5,011.87 | $8,317.64 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $1,000.00 / $1,621.81
| Facility | | $870.96 | $1,000.00 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $467.74 / $8,511.38
| Facility | | $316.23 | $467.74 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $524.81 / $9,772.37
| Facility | | $323.59 | $524.81 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $707.95 / $1,096.48
| Professional | | $389.05 | $707.95 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $8,317.64 / $8,317.64
| Facility | | $5,370.32 | $8,317.64 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,232.93 / $12,589.25
| Facility | | $6,606.93 | $10,232.93 | $12,589.25 |