- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $676.08 / $8,317.64
| Facility | | $275.42 | $676.08 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,412.54 / $2,238.72
| Facility | | $1,202.26 | $1,412.54 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $891.25 / $5,888.44
| Facility | | $316.23 | $891.25 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $851.14 / $5,128.61
| Facility | | $323.59 | $851.14 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $977.24 / $1,513.56
| Professional | | $588.84 | $977.24 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $5,623.41 / $5,623.41
| Facility | | $3,801.89 | $5,623.41 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,801.89 / $6,606.93
| Facility | | $2,884.03 | $3,801.89 | $6,606.93 |