- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $5,011.87 / $8,317.64
| Facility | | $549.54 | $5,011.87 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $416.87 / $537.03
| Professional | | $354.81 | $416.87 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $645.65 / $741.31
| Professional | | $616.60 | $645.65 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $524.81 / $851.14
| Facility | | $380.19 | $524.81 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $549.54 / $4,073.80
| Facility | | $371.54 | $549.54 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $3,467.37 / $5,754.40
| Facility | | $1,819.70 | $3,467.37 | $5,754.40 |