- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,951.21 / $14,454.40
| Facility | | $1,548.82 | $2,951.21 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,317.64 / $14,125.38
| Facility | | $5,011.87 | $8,317.64 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $4,265.80 / $6,760.83
| Facility | | $3,630.78 | $4,265.80 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $1,819.70 / $8,128.31
| Facility | | $1,380.38 | $1,819.70 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $1,862.09 / $5,888.44
| Facility | | $1,412.54 | $1,862.09 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,778.28 / $3,235.94 / $5,011.87
| Professional | | $1,778.28 | $3,235.94 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $13,489.63 / $13,489.63
| Facility | | $3,630.78 | $13,489.63 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $6,165.95 / $19,498.45
| Facility | | $2,290.87 | $6,165.95 | $19,498.45 |