- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $6,606.93 / $18,620.87
| Facility | | $1,288.25 | $6,606.93 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $4,466.84 / $9,332.54
| Facility | | $1,737.80 | $4,466.84 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $812.83 / $1,862.09
| Facility | | $562.34 | $812.83 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $588.84 / $660.69
| Professional | | $588.84 | $588.84 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $630.96 / $1,047.13
| Facility | | $467.74 | $630.96 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $10,232.93 / $16,982.44
| Facility | | $933.25 | $10,232.93 | $16,982.44 |