- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $8,317.64 / $33,113.11
| Facility | | $4,897.79 | $8,317.64 | $33,113.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $1,445.44 / $3,311.31
| Professional | | $407.38 | $1,445.44 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $8,317.64 / $14,791.08
| Facility | | $3,890.45 | $8,317.64 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $537.03 / $616.60
| Facility | | $34.67 | $537.03 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $446.68 / $512.86
| Professional | | $426.58 | $446.68 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $16,982.44 / $25,703.96
| Facility | | $1,698.24 | $16,982.44 | $25,703.96 |