- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $630.96 / $14,454.40
| Facility | | $288.40 | $630.96 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $17,378.01 / $29,512.09
| Facility | | $11,220.18 | $17,378.01 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $933.25 / $1,479.11
| Facility | | $794.33 | $933.25 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $602.56 / $3,981.07
| Facility | | $288.40 | $602.56 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $630.96 / $15,135.61
| Facility | | $295.12 | $630.96 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $741.31 / $1,122.02
| Professional | | $489.78 | $741.31 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56,234.13 / $83,176.38 / $83,176.38
| Facility | | $56,234.13 | $83,176.38 | $83,176.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $12,302.69 / $16,595.87
| Facility | | $7,762.47 | $12,302.69 | $16,595.87 |