- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $5,495.41 / $10,232.93
| Facility | | $2,238.72 | $5,495.41 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $154.88 / $575.44
| Professional | | $47.86 | $154.88 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $3,981.07 / $5,888.44
| Facility | | $1,230.27 | $3,981.07 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $575.44 / $1,737.80
| Professional | | $537.03 | $575.44 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $8,128.31 / $8,128.31
| Facility | | $8,128.31 | $8,128.31 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $4,466.84 / $16,982.44
| Facility | | $389.05 | $4,466.84 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $60.26 / $426.58
| Professional | | $47.86 | $60.26 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $9,120.11 / $17,378.01
| Facility | | $4,466.84 | $9,120.11 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $54.95 / $338.84
| Professional | | $45.71 | $54.95 | $338.84 |