- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $9,120.11 / $53,703.18
| Facility | | $2,290.87 | $9,120.11 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $562.34 / $3,311.31
| Facility | | $34.67 | $562.34 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,511.89 / $2,511.89 / $2,951.21
| Professional | | $2,511.89 | $2,511.89 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $2,570.40 / $4,168.69
| Facility | | $1,905.46 | $2,570.40 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $6,165.95 / $8,912.51
| Facility | | $478.63 | $6,165.95 | $8,912.51 |