- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $954.99 / $14,454.40
| Facility | | $446.68 | $954.99 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,317.64 / $13,182.57
| Facility | | $5,011.87 | $8,317.64 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,412.54 / $2,238.72
| Facility | | $1,202.26 | $1,412.54 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $954.99 / $9,772.37
| Facility | | $457.09 | $954.99 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $977.24 / $11,220.18
| Facility | | $457.09 | $977.24 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.83 / $1,047.13 / $1,621.81
| Professional | | $691.83 | $1,047.13 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $8,912.51 / $8,912.51
| Facility | | $6,025.60 | $8,912.51 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,232.93 / $12,589.25
| Facility | | $6,606.93 | $10,232.93 | $12,589.25 |