- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $7,244.36 / $16,595.87
| Facility | | $1,071.52 | $7,244.36 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $5,754.40 / $10,715.19
| Facility | | $2,344.23 | $5,754.40 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $676.08 / $2,570.40
| Facility | | $501.19 | $676.08 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $660.69 / $870.96
| Professional | | $660.69 | $660.69 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $549.54 / $1,023.29
| Facility | | $380.19 | $549.54 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $11,220.18 / $16,982.44
| Facility | | $1,995.26 | $11,220.18 | $16,982.44 |