- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $776.25 / $14,454.40
| Facility | | $467.74 | $776.25 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,128.31 / $13,182.57
| Facility | | $5,011.87 | $8,128.31 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,148.15 / $1,819.70
| Facility | | $977.24 | $1,148.15 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $7,244.36 / $13,489.63
| Facility | | $436.52 | $7,244.36 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $2,818.38 / $7,943.28
| Facility | | $426.58 | $2,818.38 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $933.25 / $1,621.81
| Professional | | $660.69 | $933.25 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $2,398.83 / $2,398.83
| Facility | | $977.24 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $6,165.95 / $19,498.45
| Facility | | $2,290.87 | $6,165.95 | $19,498.45 |