- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $3,630.78 / $8,317.64
| Facility | | $223.87 | $3,630.78 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $6,760.83 / $7,413.10
| Facility | | $5,888.44 | $6,760.83 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $870.96 / $977.24
| Facility | | $489.78 | $870.96 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $199.53 / $407.38
| Professional | | $165.96 | $199.53 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $446.68 / $446.68
| Professional | | $288.40 | $446.68 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $251.19 / $389.05
| Facility | | $190.55 | $251.19 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $257.04 / $870.96
| Facility | | $194.98 | $257.04 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $2,884.03 / $5,754.40
| Facility | | $512.86 | $2,884.03 | $5,754.40 |