- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,277.00 / $5,549.00 / $11,100.08
| Facility | | $4,277.00 | $5,549.00 | $11,100.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $322.02 / $537.80 / $680.96
| Professional | | $322.02 | $537.80 | $680.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $655.04 / $922.68 / $6,608.00
| Facility | | $655.04 | $922.68 | $6,608.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $532.15 / $787.36 / $1,013.93
| Facility | | $532.15 | $787.36 | $1,013.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,126.00 / $5,847.00 / $7,305.00
| Facility | | $2,126.00 | $5,847.00 | $7,305.00 |