- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $9,549.93 / $25,118.86
| Facility | | $6,918.31 | $9,549.93 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $10,471.29 / $20,417.38
| Facility | | $7,943.28 | $10,471.29 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $2,754.23 / $16,595.87
| Facility | | $1,479.11 | $2,754.23 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,235.94 / $3,311.31 / $4,677.35
| Professional | | $3,235.94 | $3,311.31 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $7,413.10 / $9,120.11
| Facility | | $6,309.57 | $7,413.10 | $9,120.11 |