- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $7,244.36 / $18,197.01
| Facility | | $2,884.03 | $7,244.36 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $8,128.31 / $15,848.93
| Facility | | $4,570.88 | $8,128.31 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $2,398.83 / $8,709.64
| Facility | | $66.07 | $2,398.83 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $1,905.46 / $1,949.84
| Facility | | $1,905.46 | $1,905.46 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $645.65 / $1,096.48
| Professional | | $281.84 | $645.65 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $707.95 / $1,230.27
| Professional | | $478.63 | $707.95 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $5,623.41 / $45,708.82
| Facility | | $5,623.41 | $5,623.41 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $707.95 / $1,122.02
| Facility | | $478.63 | $707.95 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $7,585.78 / $15,135.61
| Facility | | $3,981.07 | $7,585.78 | $15,135.61 |