- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $501.19 / $7,943.28
| Facility | | $389.05 | $501.19 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,479.11 / $2,344.23
| Facility | | $1,479.11 | $1,479.11 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $354.81 / $467.74
| Professional | | $263.03 | $354.81 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $263.03 / $489.78
| Facility | | $190.55 | $263.03 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $380.19 / $389.05
| Facility | | $323.59 | $380.19 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $263.03 / $467.74
| Facility | | $177.83 | $263.03 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $8,912.51 / $13,182.57
| Facility | | $6,025.60 | $8,912.51 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $5,495.41 / $7,413.10
| Facility | | $1,548.82 | $5,495.41 | $7,413.10 |