- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,555.52 / $5,607.18 / $14,482.00
| Facility | | $2,555.52 | $5,607.18 | $14,482.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,499.00 / $16,401.00 / $25,162.36
| Facility | | $11,499.00 | $16,401.00 | $25,162.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,156.70 / $8,363.16 / $13,489.49
| Facility | | $7,156.70 | $8,363.16 | $13,489.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,555.52 / $3,744.69 / $5,357.97
| Facility | | $2,555.52 | $3,744.69 | $5,357.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,546.89 / $3,896.74 / $7,700.00
| Facility | | $2,546.89 | $3,896.74 | $7,700.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,555.52 / $3,744.69 / $5,357.97
| Facility | | $2,555.52 | $3,744.69 | $5,357.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,760.30 / $8,862.00 / $12,045.26
| Professional | | $5,760.30 | $8,862.00 | $12,045.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,983.72 / $40,983.72 / $40,983.72
| Facility | | $40,983.72 | $40,983.72 | $40,983.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,203.00 / $4,316.80 / $19,003.00
| Facility | | $2,203.00 | $4,316.80 | $19,003.00 |