- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $3,630.78 / $15,135.61
| Facility | | $537.03 | $3,630.78 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $354.81 / $436.52
| Professional | | $295.12 | $354.81 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $602.56 / $794.33
| Professional | | $478.63 | $602.56 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $512.86 / $776.25
| Facility | | $346.74 | $512.86 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $467.74 / $7,413.10
| Facility | | $316.23 | $467.74 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $3,467.37 / $5,754.40
| Facility | | $1,737.80 | $3,467.37 | $5,754.40 |