- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $7,244.36 / $13,489.63
| Facility | | $537.03 | $7,244.36 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $6,025.60 / $11,748.98
| Facility | | $4,677.35 | $6,025.60 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $436.52 / $3,162.28
| Facility | | $245.47 | $436.52 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $630.96 / $831.76
| Professional | | $512.86 | $630.96 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $3,162.28 / $8,128.31
| Facility | | $2,398.83 | $3,162.28 | $8,128.31 |