- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $870.96 / $14,454.40
| Facility | | $467.74 | $870.96 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,128.31 / $13,489.63
| Facility | | $5,011.87 | $8,128.31 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,288.25 / $2,041.74
| Facility | | $1,096.48 | $1,288.25 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $524.81 / $8,128.31
| Facility | | $354.81 | $524.81 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $537.03 / $7,079.46
| Facility | | $354.81 | $537.03 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $870.96 / $1,348.96
| Professional | | $489.78 | $870.96 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,884.03 / $2,884.03
| Facility | | $1,096.48 | $2,884.03 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $7,413.10 / $9,120.11
| Facility | | $4,897.79 | $7,413.10 | $9,120.11 |