- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $11,481.54 / $21,877.62
| Facility | | $1,778.28 | $11,481.54 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $354.81 / $1,905.46
| Professional | | $316.23 | $354.81 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $15,848.93 / $23,988.33
| Facility | | $5,128.61 | $15,848.93 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $50.12 / $64.57
| Professional | | $44.67 | $50.12 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $14,125.38 / $14,125.38
| Facility | | $5,495.41 | $14,125.38 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $16,218.10 / $31,622.78
| Facility | | $10,715.19 | $16,218.10 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,691.53 / $2,691.53 / $2,691.53
| Professional | | $2,691.53 | $2,691.53 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $20,892.96 / $36,307.81
| Facility | | $3,467.37 | $20,892.96 | $36,307.81 |