- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $6,165.95 / $15,488.17
| Facility | | $741.31 | $6,165.95 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $9,549.93 / $9,772.37
| Facility | | $8,709.64 | $9,549.93 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $16,218.10 / $46,773.51
| Facility | | $8,511.38 | $16,218.10 | $46,773.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $630.96 / $776.25
| Professional | | $524.81 | $630.96 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.58 / $933.25 / $1,174.90
| Professional | | $758.58 | $933.25 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $912.01 / $1,380.38
| Facility | | $588.84 | $912.01 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $870.96 / $11,481.54
| Facility | | $602.56 | $870.96 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $12,302.69 / $29,512.09
| Facility | | $7,413.10 | $12,302.69 | $29,512.09 |