- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $11,481.54 / $28,183.83
| Facility | | $4,897.79 | $11,481.54 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $11,748.98 / $18,620.87
| Facility | | $6,918.31 | $11,748.98 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $2,754.23 / $9,120.11
| Facility | | $66.07 | $2,754.23 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $416.87 / $8,912.51
| Professional | | $251.19 | $416.87 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $3,715.35 / $10,471.29
| Professional | | $316.23 | $3,715.35 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $16,982.44
| Facility | | $54.95 | $56.23 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $645.65 / $9,332.54
| Facility | | $389.05 | $645.65 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $17,782.79 / $38,904.51
| Facility | | $9,772.37 | $17,782.79 | $38,904.51 |