- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $758.58 / $14,454.40
| Facility | | $478.63 | $758.58 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $7,943.28 / $12,589.25
| Facility | | $5,011.87 | $7,943.28 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $1,122.02 / $1,819.70
| Facility | | $954.99 | $1,122.02 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $7,244.36 / $13,489.63
| Facility | | $467.74 | $7,244.36 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $7,079.46 / $12,302.69
| Facility | | $436.52 | $7,079.46 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $891.25 / $1,584.89
| Professional | | $630.96 | $891.25 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $10,964.78 / $10,964.78
| Facility | | $7,585.78 | $10,964.78 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,232.93 / $13,182.57
| Facility | | $6,606.93 | $10,232.93 | $13,182.57 |