- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $7,585.78 / $18,197.01
| Facility | | $3,235.94 | $7,585.78 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $10,471.29 / $17,782.79
| Facility | | $6,025.60 | $10,471.29 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $3,388.44 / $9,549.93
| Facility | | $66.07 | $3,388.44 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,047.13 / $5,754.40
| Facility | | $707.95 | $1,047.13 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,288.25 / $4,365.16
| Professional | | $1,071.52 | $1,288.25 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $851.14 / $1,096.48 / $2,137.96
| Professional | | $851.14 | $1,096.48 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $2,137.96 / $16,982.44
| Facility | | $2,137.96 | $2,137.96 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $1,258.93 / $2,187.76
| Facility | | $954.99 | $1,258.93 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $12,022.64 / $25,703.96
| Facility | | $6,025.60 | $12,022.64 | $25,703.96 |