- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,390.73 / $4,753.58 / $15,533.50
| Facility | | $2,390.73 | $4,753.58 | $15,533.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $298.89 / $437.52 / $718.02
| Professional | | $298.89 | $437.52 | $718.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $356.51 / $395.42 / $430.81
| Facility | | $356.51 | $395.42 | $430.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $271.64 / $382.94 / $382.94
| Professional | | $271.64 | $382.94 | $382.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $571.65 / $571.65 / $571.65
| Facility | | $571.65 | $571.65 | $571.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $336.63 / $529.50 / $1,222.54
| Professional | | $336.63 | $529.50 | $1,222.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,550.47 / $3,550.47 / $3,608.28
| Facility | | $3,550.47 | $3,550.47 | $3,608.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $335.76 / $518.96 / $706.00
| Professional | | $335.76 | $518.96 | $706.00 |