- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $5,888.44 / $16,595.87
| Facility | | $1,659.59 | $5,888.44 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $6,165.95 / $13,489.63
| Facility | | $3,630.78 | $6,165.95 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $1,995.26 / $8,128.31
| Facility | | $66.07 | $1,995.26 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $1,096.48 / $2,238.72
| Facility | | $537.03 | $1,096.48 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $912.01 / $1,288.25
| Professional | | $134.90 | $912.01 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $741.31 / $1,445.44
| Professional | | $123.03 | $741.31 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $4,897.79
| Facility | | $54.95 | $56.23 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $741.31 / $1,659.59
| Facility | | $147.91 | $741.31 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $4,168.69 / $9,549.93
| Facility | | $1,819.70 | $4,168.69 | $9,549.93 |