- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $5,623.41 / $16,595.87
| Facility | | $1,548.82 | $5,623.41 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $4,466.84 / $12,022.64
| Facility | | $2,570.40 | $4,466.84 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $1,318.26 / $5,754.40
| Facility | | $66.07 | $1,318.26 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $776.25 / $1,202.26
| Facility | | $398.11 | $776.25 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $309.03 / $812.83
| Professional | | $223.87 | $309.03 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $467.74 / $891.25
| Professional | | $199.53 | $467.74 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $3,630.78 / $19,498.45
| Facility | | $3,630.78 | $3,630.78 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $478.63 / $851.14
| Facility | | $239.88 | $478.63 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $4,168.69 / $9,549.93
| Facility | | $1,819.70 | $4,168.69 | $9,549.93 |