- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $8,912.51 / $22,387.21
| Facility | | $3,630.78 | $8,912.51 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $10,471.29 / $17,782.79
| Facility | | $6,025.60 | $10,471.29 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $4,168.69 / $22,908.68
| Facility | | $66.07 | $4,168.69 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $1,995.26 / $5,011.87
| Facility | | $660.69 | $1,995.26 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $758.58 / $1,023.29
| Professional | | $478.63 | $758.58 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $776.25 / $1,479.11
| Professional | | $630.96 | $776.25 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $9,549.93 / $50,118.72
| Facility | | $9,549.93 | $9,549.93 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $912.01 / $1,513.56
| Facility | | $691.83 | $912.01 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $9,549.93 / $20,892.96
| Facility | | $4,265.80 | $9,549.93 | $20,892.96 |