- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,183.40 / $6,298.62 / $12,765.09
| Facility | | $2,183.40 | $6,298.62 | $12,765.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $716.55 / $1,215.05 / $2,091.19
| Professional | | $716.55 | $1,215.05 | $2,091.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,149.16 / $2,061.42 / $14,479.00
| Facility | | $1,149.16 | $2,061.42 | $14,479.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,279.00 / $2,180.51 / $5,275.65
| Facility | | $1,279.00 | $2,180.51 | $5,275.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,220.00 / $9,346.00 / $14,242.22
| Facility | | $8,220.00 | $9,346.00 | $14,242.22 |