- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $11,748.98 / $29,512.09
| Facility | | $1,905.46 | $11,748.98 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $33,884.42 / $66,069.34
| Facility | | $25,703.96 | $33,884.42 | $66,069.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,153.52 / $37,153.52 / $37,153.52
| Facility | | $37,153.52 | $37,153.52 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $2,041.74 / $26,302.68
| Facility | | $1,071.52 | $2,041.74 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,819.70 / $2,041.74 / $2,398.83
| Professional | | $1,819.70 | $2,041.74 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $22,908.68 / $27,542.29
| Facility | | $10,232.93 | $22,908.68 | $27,542.29 |