- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $1,230.27 / $5,888.44
| Facility | | $524.81 | $1,230.27 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $1,412.54 / $1,584.89
| Facility | | $323.59 | $1,412.54 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $758.58 / $1,230.27
| Professional | | $575.44 | $758.58 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $457.09 / $776.25
| Professional | | $416.87 | $457.09 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $602.56 / $977.24
| Facility | | $389.05 | $602.56 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $489.78 / $1,819.70
| Facility | | $346.74 | $489.78 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $6,025.60 / $13,803.84
| Facility | | $1,071.52 | $6,025.60 | $13,803.84 |