- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $891.25 / $14,454.40
| Facility | | $478.63 | $891.25 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $12,302.69 / $20,417.38
| Facility | | $9,120.11 | $12,302.69 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,288.25 / $2,089.30
| Facility | | $1,122.02 | $1,288.25 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $616.60 / $4,365.16
| Facility | | $436.52 | $616.60 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $660.69 / $14,125.38
| Facility | | $436.52 | $660.69 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $933.25 / $1,548.82
| Professional | | $512.86 | $933.25 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $27,542.29 / $27,542.29
| Facility | | $18,620.87 | $27,542.29 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $13,803.84 / $17,782.79
| Facility | | $8,912.51 | $13,803.84 | $17,782.79 |