- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $7,244.36 / $13,489.63
| Facility | | $537.03 | $7,244.36 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $15,488.17 / $31,622.78
| Facility | | $12,302.69 | $15,488.17 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $2,290.87 / $2,290.87
| Facility | | $2,290.87 | $2,290.87 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $645.65 / $8,709.64
| Facility | | $323.59 | $645.65 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $630.96 / $724.44
| Professional | | $549.54 | $630.96 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,548.82 / $4,570.88
| Facility | | $1,096.48 | $1,548.82 | $4,570.88 |