- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $4,897.79 / $13,182.57
| Facility | | $1,148.15 | $4,897.79 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.65 / $1,230.27 / $3,548.13
| Professional | | $645.65 | $1,230.27 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $398.11 / $7,079.46
| Facility | | $34.67 | $398.11 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $12,022.64 / $22,908.68
| Facility | | $6,165.95 | $12,022.64 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.81 / $346.74 / $524.81
| Professional | | $39.81 | $346.74 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $10,232.93 / $15,848.93
| Facility | | $3,311.31 | $10,232.93 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.67 / $39.81 / $60.26
| Professional | | $34.67 | $39.81 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $309.03 / $309.03
| Professional | | $309.03 | $309.03 | $309.03 |