- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $12,022.64 / $18,197.01
| Facility | | $2,691.53 | $12,022.64 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $18,620.87 / $34,673.69
| Facility | | $6,606.93 | $18,620.87 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,659.59 / $7,413.10
| Facility | | $1,122.02 | $1,659.59 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,737.80 / $1,737.80 / $2,290.87
| Professional | | $1,737.80 | $1,737.80 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,348.96 / $2,344.23
| Facility | | $977.24 | $1,348.96 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $20,417.38 / $25,703.96
| Facility | | $4,677.35 | $20,417.38 | $25,703.96 |