- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,348.96 / $14,454.40
| Facility | | $724.44 | $1,348.96 | $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
- $1,659.59 / $1,949.84 / $3,090.30
| Facility | | $1,659.59 | $1,949.84 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $870.96 / $3,548.13
| Facility | | $630.96 | $870.96 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $954.99 / $10,964.78
| Facility | | $660.69 | $954.99 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $831.76 / $1,513.56 / $2,344.23
| Professional | | $831.76 | $1,513.56 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $16,218.10 / $16,218.10
| Facility | | $10,964.78 | $16,218.10 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,232.93 / $14,454.40
| Facility | | $6,606.93 | $10,232.93 | $14,454.40 |