- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $1,258.93 / $16,218.10
| Facility | | $363.08 | $1,258.93 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,964.78 / $18,197.01
| Facility | | $6,606.93 | $10,964.78 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,202.26 / $1,995.26
| Facility | | $1,023.29 | $1,202.26 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $794.33 / $3,981.07
| Facility | | $380.19 | $794.33 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $812.83 / $15,135.61
| Facility | | $389.05 | $812.83 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $912.01 / $1,380.38
| Professional | | $602.56 | $912.01 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $16,595.87 / $24,547.09
| Facility | | $8,709.64 | $16,595.87 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $12,302.69 / $16,595.87
| Facility | | $7,585.78 | $12,302.69 | $16,595.87 |