- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $891.25 / $14,454.40
| Facility | | $478.63 | $891.25 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,318.26 / $2,137.96
| Facility | | $1,148.15 | $1,318.26 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $524.81 / $3,467.37
| Facility | | $354.81 | $524.81 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $562.34 / $7,244.36
| Facility | | $354.81 | $562.34 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $1,047.13 / $1,621.81
| Professional | | $575.44 | $1,047.13 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $7,943.28 / $7,943.28
| Facility | | $5,370.32 | $7,943.28 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $7,413.10 / $9,120.11
| Facility | | $4,897.79 | $7,413.10 | $9,120.11 |