- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $2,818.38 / $8,128.31
| Facility | | $436.52 | $2,818.38 | $8,128.31 |
- 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
- $426.58 / $794.33 / $870.96
| Facility | | $426.58 | $794.33 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $251.19 / $501.19
| Professional | | $208.93 | $251.19 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $407.38 / $549.54
| Professional | | $380.19 | $407.38 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $354.81 / $562.34
| Facility | | $239.88 | $354.81 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $346.74 / $1,071.52
| Facility | | $245.47 | $346.74 | $1,071.52 |
- 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 |