- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $1,258.93 / $13,489.63
| Facility | | $426.58 | $1,258.93 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $15,135.61 / $26,302.68
| Facility | | $7,585.78 | $15,135.61 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $1,862.09 / $3,090.30
| Facility | | $1,584.89 | $1,862.09 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $831.76 / $4,677.35
| Facility | | $478.63 | $831.76 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $870.96 / $7,762.47
| Facility | | $478.63 | $870.96 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $794.33 / $1,318.26 / $1,995.26
| Professional | | $794.33 | $1,318.26 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $18,197.01 / $26,915.35
| Facility | | $9,772.37 | $18,197.01 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $7,413.10 / $9,120.11
| Facility | | $4,897.79 | $7,413.10 | $9,120.11 |