- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,238.72 / $4,677.35
| Facility | | $1,548.82 | $2,238.72 | $4,677.35 |
- 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
- $2,754.23 / $3,162.28 / $5,128.61
| Facility | | $2,754.23 | $3,162.28 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $4,677.35 / $9,549.93
| Facility | | $1,122.02 | $4,677.35 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $7,244.36 / $15,848.93
| Facility | | $1,122.02 | $7,244.36 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $977.24 / $2,089.30 / $3,235.94
| Professional | | $977.24 | $2,089.30 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $16,982.44 / $16,982.44
| Facility | | $11,481.54 | $16,982.44 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $9,549.93 / $9,549.93
| Facility | | $9,549.93 | $9,549.93 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $12,022.64 / $16,218.10
| Facility | | $7,585.78 | $12,022.64 | $16,218.10 |