- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $2,570.40 / $7,079.46
| Facility | | $575.44 | $2,570.40 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $660.69 / $870.96
| Facility | | $323.59 | $660.69 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $660.69 / $1,071.52
| Professional | | $501.19 | $660.69 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $630.96 / $758.58
| Professional | | $588.84 | $630.96 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $602.56 / $954.99
| Facility | | $398.11 | $602.56 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $501.19 / $1,737.80
| Facility | | $398.11 | $501.19 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $2,818.38 / $5,754.40
| Facility | | $512.86 | $2,818.38 | $5,754.40 |