- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $602.56 / $7,943.28
| Facility | | $478.63 | $602.56 | $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
- $323.59 / $436.52 / $549.54
| Professional | | $323.59 | $436.52 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $354.81 / $602.56
| Facility | | $234.42 | $354.81 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $457.09 / $478.63
| Facility | | $389.05 | $457.09 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $354.81 / $588.84
| Facility | | $223.87 | $354.81 | $588.84 |
- 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 |