- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $512.86 / $7,943.28
| Facility | | $407.38 | $512.86 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,479.11 / $2,290.87
| Facility | | $1,479.11 | $1,479.11 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $371.54 / $478.63
| Professional | | $275.42 | $371.54 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $302.00 / $512.86
| Facility | | $199.53 | $302.00 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $389.05 / $407.38
| Facility | | $331.13 | $389.05 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $309.03 / $512.86
| Facility | | $190.55 | $309.03 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $6,025.60 / $7,244.36
| Facility | | $4,365.16 | $6,025.60 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $5,495.41 / $7,413.10
| Facility | | $1,548.82 | $5,495.41 | $7,413.10 |