- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $3,890.45 / $9,772.37
| Facility | | $1,071.52 | $3,890.45 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $134.90 / $162.18
| Professional | | $91.20 | $134.90 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $5,495.41 / $12,022.64
| Facility | | $2,290.87 | $5,495.41 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $158.49 / $251.19
| Professional | | $125.89 | $158.49 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $707.95 / $3,467.37
| Facility | | $245.47 | $707.95 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $676.08 / $676.08
| Professional | | $229.09 | $676.08 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,818.38 / $6,760.83
| Facility | | $660.69 | $2,818.38 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $169.82 / $295.12
| Professional | | $120.23 | $169.82 | $295.12 |