- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $45,708.82 / $63,095.73
| Facility | | $380.19 | $45,708.82 | $63,095.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $281.84 / $954.99
| Professional | | $190.55 | $281.84 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $4,365.16 / $63,095.73
| Facility | | $3,715.35 | $4,365.16 | $63,095.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $407.38 / $524.81
| Professional | | $239.88 | $407.38 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,773.51 / $57,543.99 / $70,794.58
| Facility | | $46,773.51 | $57,543.99 | $70,794.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $354.81 / $588.84
| Professional | | $251.19 | $354.81 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $407.38
| Professional | | $371.54 | $371.54 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $6,025.60 / $9,332.54
| Facility | | $3,388.44 | $6,025.60 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $302.00 / $630.96
| Professional | | $208.93 | $302.00 | $630.96 |