- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $891.25 / $6,606.93
| Facility | | $512.86 | $891.25 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $1,949.84 / $2,398.83
| Facility | | $1,949.84 | $1,949.84 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $645.65 / $977.24
| Professional | | $457.09 | $645.65 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $457.09 / $831.76
| Facility | | $281.84 | $457.09 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $741.31 / $794.33
| Facility | | $524.81 | $741.31 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $457.09 / $794.33
| Facility | | $263.03 | $457.09 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $10,232.93 / $12,022.64
| Facility | | $7,413.10 | $10,232.93 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $5,495.41 / $12,302.69
| Facility | | $1,548.82 | $5,495.41 | $12,302.69 |