- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $5,370.32 / $9,772.37
| Facility | | $549.54 | $5,370.32 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $776.25 / $776.25
| Facility | | $776.25 | $776.25 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $478.63 / $562.34
| Professional | | $380.19 | $478.63 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $602.56 / $912.01
| Professional | | $489.78 | $602.56 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $501.19 / $794.33
| Facility | | $371.54 | $501.19 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $501.19 / $3,388.44
| Facility | | $346.74 | $501.19 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $3,311.31 / $5,754.40
| Facility | | $1,737.80 | $3,311.31 | $5,754.40 |