- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $5,495.41 / $17,378.01
| Facility | | $1,949.84 | $5,495.41 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $14,791.08 / $22,908.68
| Facility | | $9,332.54 | $14,791.08 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $9,120.11 / $20,892.96
| Facility | | $8,317.64 | $9,120.11 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $691.83 / $933.25
| Professional | | $10.47 | $691.83 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $4,786.30 / $20,417.38
| Facility | | $2,951.21 | $4,786.30 | $20,417.38 |