- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $5,495.41 / $16,595.87
| Facility | | $323.59 | $5,495.41 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,570.88 / $7,079.46
| Facility | | $2,630.27 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $478.63 / $794.33
| Facility | | $407.38 | $478.63 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $309.03 / $3,548.13
| Facility | | $154.88 | $309.03 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $323.59 / $5,248.07
| Facility | | $154.88 | $323.59 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $354.81 / $549.54
| Professional | | $234.42 | $354.81 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $3,235.94 / $4,786.30
| Facility | | $1,737.80 | $3,235.94 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,801.89 / $6,456.54
| Facility | | $2,884.03 | $3,801.89 | $6,456.54 |