- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $1,148.15 / $14,454.40
| Facility | | $537.03 | $1,148.15 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $15,135.61 / $26,302.68
| Facility | | $10,715.19 | $15,135.61 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,698.24 / $2,818.38
| Facility | | $1,445.44 | $1,698.24 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $1,148.15 / $3,981.07
| Facility | | $549.54 | $1,148.15 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $1,230.27 / $11,481.54
| Facility | | $549.54 | $1,230.27 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $812.83 / $1,230.27 / $1,862.09
| Professional | | $812.83 | $1,230.27 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $17,378.01 / $25,703.96
| Facility | | $9,332.54 | $17,378.01 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,232.93 / $14,454.40
| Facility | | $6,606.93 | $10,232.93 | $14,454.40 |