- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $7,943.28 / $14,454.40
| Facility | | $2,454.71 | $7,943.28 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $11,220.18 / $21,877.62
| Facility | | $8,511.38 | $11,220.18 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,137.96 / $7,943.28
| Facility | | $1,318.26 | $2,137.96 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,951.21 / $3,090.30 / $4,168.69
| Professional | | $2,951.21 | $3,090.30 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $3,162.28 / $8,128.31
| Facility | | $1,737.80 | $3,162.28 | $8,128.31 |