- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $7,585.78 / $18,620.87
| Facility | | $2,951.21 | $7,585.78 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $8,128.31 / $15,848.93
| Facility | | $4,570.88 | $8,128.31 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $4,466.84 / $14,791.08
| Facility | | $66.07 | $4,466.84 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $316.23 / $426.58
| Professional | | $269.15 | $316.23 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $354.81 / $645.65
| Professional | | $281.84 | $354.81 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $13,489.63
| Facility | | $54.95 | $56.23 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $380.19 / $588.84
| Facility | | $295.12 | $380.19 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $12,302.69 / $25,703.96
| Facility | | $6,456.54 | $12,302.69 | $25,703.96 |