- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $7,585.78 / $19,054.61
| Facility | | $2,951.21 | $7,585.78 | $19,054.61 |
- 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
- $346.74 / $398.11 / $537.03
| Professional | | $346.74 | $398.11 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $457.09 / $851.14
| Professional | | $363.08 | $457.09 | $851.14 |
- 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
- $380.19 / $478.63 / $758.58
| Facility | | $380.19 | $478.63 | $758.58 |
- 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 |