- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $4,265.80 / $14,454.40
| Facility | | $1,905.46 | $4,265.80 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $16,218.10 / $27,542.29
| Facility | | $11,748.98 | $16,218.10 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $6,309.57 / $10,000.00
| Facility | | $5,370.32 | $6,309.57 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $6,918.31 / $13,489.63
| Facility | | $2,238.72 | $6,918.31 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $3,801.89 / $7,943.28
| Facility | | $2,089.30 | $3,801.89 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,884.03 / $5,623.41 / $8,912.51
| Professional | | $2,884.03 | $5,623.41 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $40,738.03 / $40,738.03
| Facility | | $5,370.32 | $40,738.03 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $6,165.95 / $19,498.45
| Facility | | $2,290.87 | $6,165.95 | $19,498.45 |