- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $10,471.29 / $22,908.68
| Facility | | $3,715.35 | $10,471.29 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $6,165.95 / $13,489.63
| Facility | | $3,630.78 | $6,165.95 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $891.25 / $5,754.40
| Facility | | $66.07 | $891.25 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $524.81 / $741.31
| Professional | | $346.74 | $524.81 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $660.69 / $1,202.26
| Professional | | $501.19 | $660.69 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $4,073.80
| Facility | | $54.95 | $56.23 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $741.31 / $1,174.90
| Facility | | $575.44 | $741.31 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $1,548.82 / $6,456.54
| Facility | | $588.84 | $1,548.82 | $6,456.54 |