- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $5,011.87 / $12,589.25
| Facility | | $2,344.23 | $5,011.87 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,442.29 / $30,199.52 / $58,884.37
| Facility | | $23,442.29 | $30,199.52 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,442.29 / $23,442.29 / $23,442.29
| Facility | | $23,442.29 | $23,442.29 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $501.19 / $26,302.68
| Facility | | $263.03 | $501.19 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $707.95 / $1,000.00
| Professional | | $588.84 | $707.95 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,442.29 / $23,442.29 / $23,442.29
| Facility | | $23,442.29 | $23,442.29 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $8,912.51 / $23,988.33
| Facility | | $6,309.57 | $8,912.51 | $23,988.33 |