- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $10,471.29 / $18,197.01
| Facility | | $1,479.11 | $10,471.29 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $5,128.61 / $9,772.37
| Facility | | $2,089.30 | $5,128.61 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $954.99 / $1,862.09
| Facility | | $562.34 | $954.99 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.65 / $645.65 / $741.31
| Professional | | $645.65 | $645.65 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $707.95 / $1,174.90
| Facility | | $524.81 | $707.95 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $12,589.25 / $22,387.21
| Facility | | $1,230.27 | $12,589.25 | $22,387.21 |