- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $562.34 / $7,943.28
| Facility | | $457.09 | $562.34 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,344.23 / $2,344.23
| Facility | | $2,344.23 | $2,344.23 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $416.87 / $524.81
| Professional | | $309.03 | $416.87 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $309.03 / $575.44
| Facility | | $223.87 | $309.03 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $436.52 / $457.09
| Facility | | $371.54 | $436.52 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $309.03 / $549.54
| Facility | | $208.93 | $309.03 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $6,025.60 / $7,244.36
| Facility | | $4,365.16 | $6,025.60 | $7,244.36 |
- 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 |