- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $15,135.61 / $23,988.33
| Facility | | $2,344.23 | $15,135.61 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $1,659.59 / $8,511.38
| Facility | | $1,659.59 | $1,659.59 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,621.81 / $2,238.72 / $2,754.23
| Professional | | $1,621.81 | $2,238.72 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,479.11 / $3,019.95
| Facility | | $1,148.15 | $1,479.11 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $2,290.87 / $2,344.23
| Facility | | $1,949.84 | $2,290.87 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,513.56 / $2,570.40
| Facility | | $1,071.52 | $1,513.56 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,442.29 / $32,359.37 / $38,904.51
| Facility | | $23,442.29 | $32,359.37 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $20,892.96 / $39,810.72
| Facility | | $2,818.38 | $20,892.96 | $39,810.72 |