- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $9,549.93 / $22,908.68
| Facility | | $3,715.35 | $9,549.93 | $22,908.68 |
- 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 / $4,570.88 / $11,748.98
| Facility | | $66.07 | $4,570.88 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $2,951.21 / $4,073.80
| Facility | | $707.95 | $2,951.21 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $851.14 / $1,148.15
| Professional | | $501.19 | $851.14 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.83 / $870.96 / $1,862.09
| Professional | | $691.83 | $870.96 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $33,884.42 / $33,884.42
| Facility | | $11,748.98 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $1,023.29 / $1,698.24
| Facility | | $776.25 | $1,023.29 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $12,022.64 / $25,703.96
| Facility | | $6,309.57 | $12,022.64 | $25,703.96 |