- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $11,481.54 / $77,624.71
| Facility | | $7,244.36 | $11,481.54 | $77,624.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,113.11 / $43,651.58 / $85,113.80
| Facility | | $33,113.11 | $43,651.58 | $85,113.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $2,570.40 / $52,480.75
| Facility | | $1,202.26 | $2,570.40 | $52,480.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,630.27 / $2,818.38 / $3,801.89
| Professional | | $2,630.27 | $2,818.38 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $29,512.09 / $45,708.82
| Facility | | $12,022.64 | $29,512.09 | $45,708.82 |