- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $8,912.51 / $44,668.36
| Facility | | $4,570.88 | $8,912.51 | $44,668.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $912.01 / $1,148.15 / $1,148.15
| Professional | | $912.01 | $1,148.15 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $23,988.33 / $36,307.81
| Facility | | $9,120.11 | $23,988.33 | $36,307.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.98 / $4.57
| Professional | | $3.02 | $3.98 | $4.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $31,622.78 / $47,863.01
| Facility | | $13,803.84 | $31,622.78 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $15,135.61 / $48,977.88
| Facility | | $9,332.54 | $15,135.61 | $48,977.88 |