- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $4,897.79 / $37,153.52
| Facility | | $524.81 | $4,897.79 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $446.68 / $831.76
| Professional | | $371.54 | $446.68 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $56,234.13 / $97,723.72
| Facility | | $28,183.83 | $56,234.13 | $97,723.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $537.03 / $812.83
| Professional | | $331.13 | $537.03 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $371.54 / $407.38
| Facility | | $346.74 | $371.54 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $602.56 / $794.33
| Facility | | $389.05 | $602.56 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $478.63 / $1,071.52
| Professional | | $380.19 | $478.63 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $21,877.62 / $47,863.01
| Facility | | $14,454.40 | $21,877.62 | $47,863.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $501.19 / $794.33
| Professional | | $346.74 | $501.19 | $794.33 |