- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $5,248.07 / $26,915.35
| Facility | | $524.81 | $5,248.07 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $25,118.86 / $25,118.86
| Facility | | $22,387.21 | $25,118.86 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,547.09 / $35,481.34 / $45,708.82
| Facility | | $24,547.09 | $35,481.34 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $295.12 / $363.08
| Professional | | $245.47 | $295.12 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $794.33 / $794.33 / $794.33
| Professional | | $794.33 | $794.33 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $537.03 / $891.25
| Facility | | $288.40 | $537.03 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $562.34 / $10,000.00
| Facility | | $309.03 | $562.34 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $1,905.46 / $17,378.01
| Facility | | $229.09 | $1,905.46 | $17,378.01 |