- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $1,584.89 / $8,912.51
| Facility | | $316.23 | $1,584.89 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $6,760.83 / $7,413.10
| Facility | | $5,888.44 | $6,760.83 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $257.04 / $316.23
| Professional | | $213.80 | $257.04 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $457.09 / $602.56
| Professional | | $363.08 | $457.09 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $380.19 / $575.44
| Facility | | $251.19 | $380.19 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $346.74 / $43,651.58
| Facility | | $239.88 | $346.74 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $33,884.42 / $74,131.02
| Facility | | $16,595.87 | $33,884.42 | $74,131.02 |