- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $2,570.40 / $7,079.46
| Facility | | $229.09 | $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 / $794.33 / $870.96
| Facility | | $323.59 | $794.33 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $537.03 / $912.01
| Professional | | $371.54 | $537.03 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $208.93 / $616.60
| Professional | | $186.21 | $208.93 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $263.03 / $660.69
| Facility | | $144.54 | $263.03 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $173.78 / $1,096.48
| Facility | | $134.90 | $173.78 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $6,025.60 / $13,803.84
| Facility | | $1,071.52 | $6,025.60 | $13,803.84 |