- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $2,398.83 / $9,772.37
| Facility | | $1,071.52 | $2,398.83 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $537.03 / $891.25
| Professional | | $245.47 | $537.03 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $4,677.35 / $6,309.57
| Facility | | $3,467.37 | $4,677.35 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $588.84 / $1,258.93
| Professional | | $229.09 | $588.84 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $741.31 / $1,737.80
| Professional | | $331.13 | $741.31 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $9,549.93 / $9,549.93
| Facility | | $9,549.93 | $9,549.93 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $676.08 / $1,479.11
| Professional | | $281.84 | $676.08 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $9,549.93 / $9,549.93
| Facility | | $9,549.93 | $9,549.93 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $776.25 / $1,737.80
| Professional | | $363.08 | $776.25 | $1,737.80 |