- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,248.49 / $47,224.22 / $62,495.07
| Facility | | $45,248.49 | $47,224.22 | $62,495.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650.00 / $2,937.32 / $58,742.00
| Facility | | $650.00 | $2,937.32 | $58,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $978.51 / $1,235.47 / $3,032.95
| Professional | | $978.51 | $1,235.47 | $3,032.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,564.71 / $6,333.89 / $38,874.37
| Facility | | $2,564.71 | $6,333.89 | $38,874.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,300.55 / $1,424.54 / $1,492.37
| Professional | | $1,300.55 | $1,424.54 | $1,492.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $942.00 / $1,600.09 / $2,689.68
| Professional | | $942.00 | $1,600.09 | $2,689.68 |