- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $10,471.29 / $18,197.01
| Facility | | $1,047.13 | $10,471.29 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $4,073.80 / $7,762.47
| Facility | | $1,698.24 | $4,073.80 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $660.69 / $1,096.48
| Facility | | $660.69 | $660.69 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.83 / $691.83 / $891.25
| Professional | | $691.83 | $691.83 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $512.86 / $831.76
| Facility | | $371.54 | $512.86 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $10,964.78 / $16,982.44
| Facility | | $1,995.26 | $10,964.78 | $16,982.44 |