- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $11,481.54 / $26,915.35
| Facility | | $4,897.79 | $11,481.54 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $11,748.98 / $18,620.87
| Facility | | $6,918.31 | $11,748.98 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $7,762.47 / $28,840.32
| Facility | | $66.07 | $7,762.47 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $12,882.50 / $15,135.61
| Facility | | $12,882.50 | $12,882.50 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $512.86 / $758.58
| Professional | | $398.11 | $512.86 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $562.34 / $1,122.02
| Professional | | $426.58 | $562.34 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,118.72 / $50,118.72 / $57,543.99
| Facility | | $50,118.72 | $50,118.72 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $1,071.52 / $2,089.30
| Facility | | $537.03 | $1,071.52 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $18,197.01 / $38,904.51
| Facility | | $9,772.37 | $18,197.01 | $38,904.51 |