- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $3,630.78 / $14,791.08
| Facility | | $1,258.93 | $3,630.78 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $8,709.64 / $12,302.69
| Facility | | $5,888.44 | $8,709.64 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $524.81 / $616.60
| Facility | | $489.78 | $524.81 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,202.26 / $1,949.84
| Professional | | $1,000.00 | $1,202.26 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,380.38 / $2,290.87
| Professional | | $1,318.26 | $1,380.38 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,445.44 / $2,187.76
| Facility | | $1,071.52 | $1,445.44 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,318.26 / $4,786.30
| Facility | | $1,047.13 | $1,318.26 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $11,748.98 / $26,302.68
| Facility | | $2,511.89 | $11,748.98 | $26,302.68 |