- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $8,128.31 / $26,302.68
| Facility | | $2,344.23 | $8,128.31 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $933.25 / $933.25 / $19,054.61
| Professional | | $933.25 | $933.25 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $15,848.93 / $41,686.94
| Facility | | $6,025.60 | $15,848.93 | $41,686.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.02 / $3.98 / $3.98
| Professional | | $0.02 | $3.98 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $18,197.01 / $39,810.72
| Facility | | $8,128.31 | $18,197.01 | $39,810.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,096.48 / $1,096.48
| Professional | | $1,096.48 | $1,096.48 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $14,791.08 / $41,686.94
| Facility | | $3,715.35 | $14,791.08 | $41,686.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15,488.17 / $40,738.03 / $69,183.10
| Professional | | $15,488.17 | $40,738.03 | $69,183.10 |