- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $5,370.32 / $10,715.19
| Facility | | $478.63 | $5,370.32 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $11,220.18 / $12,302.69
| Facility | | $9,772.37 | $11,220.18 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $3,235.94 / $8,511.38
| Professional | | $288.40 | $3,235.94 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,760.83 / $8,128.31 / $8,511.38
| Professional | | $6,760.83 | $8,128.31 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $2,570.40 / $6,606.93
| Facility | | $371.54 | $2,570.40 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $489.78 / $10,964.78
| Facility | | $323.59 | $489.78 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $12,882.50 / $29,512.09
| Facility | | $7,762.47 | $12,882.50 | $29,512.09 |