- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,862.09 / $2,398.83
| Facility | | $1,258.93 | $1,862.09 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $446.68 / $776.25
| Professional | | $354.81 | $446.68 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,884.42 / $40,738.03 / $54,954.09
| Facility | | $33,884.42 | $40,738.03 | $54,954.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $416.87 / $489.78
| Professional | | $288.40 | $416.87 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $549.54 / $1,318.26
| Professional | | $346.74 | $549.54 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $18,197.01 / $37,153.52
| Facility | | $7,762.47 | $18,197.01 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $398.11 / $588.84
| Professional | | $281.84 | $398.11 | $588.84 |