- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $9,120.11 / $18,197.01
| Facility | | $891.25 | $9,120.11 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $3,715.35 / $6,918.31
| Facility | | $1,548.82 | $3,715.35 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $707.95 / $1,096.48
| Facility | | $575.44 | $707.95 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $776.25
| Professional | | $501.19 | $501.19 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $426.58 / $724.44
| Facility | | $331.13 | $426.58 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $6,760.83 / $10,471.29
| Facility | | $1,479.11 | $6,760.83 | $10,471.29 |