- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,230.27 / $14,454.40
| Facility | | $724.44 | $1,230.27 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,964.78 / $18,197.01
| Facility | | $6,606.93 | $10,964.78 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $1,862.09 / $2,951.21
| Facility | | $1,584.89 | $1,862.09 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $4,466.84 / $8,912.51
| Facility | | $707.95 | $4,466.84 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $7,585.78 / $15,848.93
| Facility | | $660.69 | $7,585.78 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.44 / $1,380.38 / $2,187.76
| Professional | | $724.44 | $1,380.38 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $16,595.87 / $16,595.87
| Facility | | $11,220.18 | $16,595.87 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $12,302.69 / $16,218.10
| Facility | | $7,585.78 | $12,302.69 | $16,218.10 |