- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $630.96 / $1,905.46
| Facility | | $316.23 | $630.96 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $10,232.93 / $17,378.01
| Facility | | $6,165.95 | $10,232.93 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,174.90 / $1,862.09
| Facility | | $1,000.00 | $1,174.90 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $776.25 / $3,715.35
| Facility | | $316.23 | $776.25 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $794.33 / $8,317.64
| Facility | | $309.03 | $794.33 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $912.01 / $1,380.38
| Professional | | $446.68 | $912.01 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $14,454.40 / $14,454.40
| Facility | | $9,772.37 | $14,454.40 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $7,413.10 / $9,120.11
| Facility | | $4,897.79 | $7,413.10 | $9,120.11 |