- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $3,630.78 / $8,317.64
| Facility | | $269.15 | $3,630.78 | $8,317.64 |
- 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
- $457.09 / $870.96 / $977.24
| Facility | | $457.09 | $870.96 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $245.47 / $457.09
| Professional | | $204.17 | $245.47 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $371.54 / $537.03
| Professional | | $346.74 | $371.54 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $331.13 / $537.03
| Facility | | $234.42 | $331.13 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $316.23 / $1,047.13
| Facility | | $239.88 | $316.23 | $1,047.13 |
- 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 |