- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $7,762.47 / $20,417.38
| Facility | | $1,819.70 | $7,762.47 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $7,413.10 / $9,332.54
| Facility | | $6,606.93 | $7,413.10 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $2,691.53 / $3,311.31
| Facility | | $616.60 | $2,691.53 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $891.25 / $1,071.52 / $1,905.46
| Professional | | $891.25 | $1,071.52 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,659.59 / $2,454.71
| Professional | | $1,479.11 | $1,659.59 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,412.54 / $2,137.96
| Facility | | $1,047.13 | $1,412.54 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,348.96 / $4,073.80
| Facility | | $1,071.52 | $1,348.96 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $10,471.29 / $23,988.33
| Facility | | $2,137.96 | $10,471.29 | $23,988.33 |