- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $5,370.32 / $10,964.78
| Facility | | $776.25 | $5,370.32 | $10,964.78 |
- 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
- $602.56 / $1,412.54 / $1,862.09
| Facility | | $602.56 | $1,412.54 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $645.65 / $1,071.52
| Professional | | $537.03 | $645.65 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $645.65 / $912.01
| Professional | | $602.56 | $645.65 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $707.95 / $1,096.48
| Facility | | $537.03 | $707.95 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $645.65 / $2,398.83
| Facility | | $512.86 | $645.65 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $8,317.64 / $17,378.01
| Facility | | $1,318.26 | $8,317.64 | $17,378.01 |