- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $3,467.37 / $8,709.64
| Facility | | $537.03 | $3,467.37 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $537.03 / $1,230.27
| Professional | | $125.89 | $537.03 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $5,011.87 / $13,489.63
| Facility | | $2,511.89 | $5,011.87 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $645.65 / $1,584.89
| Professional | | $147.91 | $645.65 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $1,659.59 / $4,466.84
| Facility | | $223.87 | $1,659.59 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $426.58 / $1,412.54
| Professional | | $151.36 | $426.58 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $5,011.87 / $12,022.64
| Facility | | $1,318.26 | $5,011.87 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $501.19 / $1,258.93
| Professional | | $128.82 | $501.19 | $1,258.93 |