- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $933.25 / $14,454.40
| Facility | | $446.68 | $933.25 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $7,943.28 / $12,589.25
| Facility | | $5,011.87 | $7,943.28 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,380.38 / $2,344.23
| Facility | | $1,202.26 | $1,380.38 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $912.01 / $7,244.36
| Facility | | $446.68 | $912.01 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $933.25 / $8,317.64
| Facility | | $457.09 | $933.25 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $1,047.13 / $1,584.89
| Professional | | $676.08 | $1,047.13 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $6,025.60 / $8,912.51
| Facility | | $3,235.94 | $6,025.60 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $7,413.10 / $9,120.11
| Facility | | $4,897.79 | $7,413.10 | $9,120.11 |