- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $799.54 / $7,920.26 / $60,427.30
| Facility | | $799.54 | $7,920.26 | $60,427.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $625.04 / $894.82 / $1,018.64
| Professional | | $625.04 | $894.82 | $1,018.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $388.05 / $786.66 / $1,157.90
| Facility | | $388.05 | $786.66 | $1,157.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $556.71 / $761.41 / $813.28
| Facility | | $556.71 | $761.41 | $813.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $538.55 / $953.37 / $1,157.90
| Facility | | $538.55 | $953.37 | $1,157.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87,501.02 / $109,608.03 / $135,174.41
| Facility | | $87,501.02 | $109,608.03 | $135,174.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,425.00 / $64,404.00 / $94,117.00
| Facility | | $7,425.00 | $64,404.00 | $94,117.00 |