- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $7,943.28 / $16,595.87
| Facility | | $1,698.24 | $7,943.28 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $562.34 / $2,454.71
| Facility | | $34.67 | $562.34 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,862.09 / $1,862.09 / $2,238.72
| Professional | | $1,862.09 | $1,862.09 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $1,862.09 / $3,019.95
| Facility | | $1,380.38 | $1,862.09 | $3,019.95 |
- 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 |