- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $1,174.90 / $14,454.40
| Facility | | $549.54 | $1,174.90 | $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
- $1,479.11 / $1,737.80 / $2,884.03
| Facility | | $1,479.11 | $1,737.80 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $1,148.15 / $3,981.07
| Facility | | $562.34 | $1,148.15 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $1,174.90 / $11,220.18
| Facility | | $575.44 | $1,174.90 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $831.76 / $1,258.93 / $1,949.84
| Professional | | $831.76 | $1,258.93 | $1,949.84 |
- 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
- $6,606.93 / $10,232.93 / $12,589.25
| Facility | | $6,606.93 | $10,232.93 | $12,589.25 |