- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $7,762.47 / $19,054.61
| Facility | | $3,090.30 | $7,762.47 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $7,943.28 / $16,982.44
| Facility | | $4,570.88 | $7,943.28 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $2,630.27 / $8,709.64
| Facility | | $66.07 | $2,630.27 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,380.38 / $57,543.99
| Facility | | $1,174.90 | $1,380.38 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $831.76 / $1,288.25
| Professional | | $549.54 | $831.76 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $831.76 / $1,096.48 / $2,089.30
| Professional | | $831.76 | $1,096.48 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $45,708.82 / $45,708.82
| Facility | | $7,079.46 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,148.15 / $1,949.84
| Facility | | $891.25 | $1,148.15 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $7,585.78 / $15,135.61
| Facility | | $3,890.45 | $7,585.78 | $15,135.61 |