- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,238.72 / $13,182.57
| Facility | | $660.69 | $2,238.72 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $691.83 / $851.14
| Professional | | $309.03 | $691.83 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $691.83 / $7,943.28
| Facility | | $446.68 | $691.83 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $645.65 / $707.95
| Facility | | $549.54 | $645.65 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $575.44 / $851.14
| Facility | | $389.05 | $575.44 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $35,481.34 / $44,668.36
| Facility | | $28,183.83 | $35,481.34 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $26,302.68 / $38,904.51
| Facility | | $21,379.62 | $26,302.68 | $38,904.51 |