- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $13,489.63 / $22,387.21
| Facility | | $2,570.40 | $13,489.63 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,698.24 / $2,238.72 / $2,951.21
| Professional | | $1,698.24 | $2,238.72 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $2,398.83 / $19,054.61
| Facility | | $1,445.44 | $2,398.83 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $2,344.23 / $2,454.71
| Facility | | $1,862.09 | $2,344.23 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,778.28 / $3,019.95
| Facility | | $1,258.93 | $1,778.28 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91,201.08 / $114,815.36 / $141,253.75
| Facility | | $91,201.08 | $114,815.36 | $141,253.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $60,255.96 / $144,543.98
| Facility | | $7,413.10 | $60,255.96 | $144,543.98 |