- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $2,398.83 / $8,317.64
| Facility | | $416.87 | $2,398.83 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $10,232.93 / $17,378.01
| Facility | | $6,165.95 | $10,232.93 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,230.27 / $1,949.84
| Facility | | $1,047.13 | $1,230.27 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $4,677.35 / $8,912.51
| Facility | | $446.68 | $4,677.35 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $5,495.41 / $8,709.64
| Facility | | $446.68 | $5,495.41 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $933.25 / $1,584.89
| Professional | | $478.63 | $933.25 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $14,454.40 / $14,454.40
| Facility | | $9,772.37 | $14,454.40 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $7,413.10 / $9,120.11
| Facility | | $4,897.79 | $7,413.10 | $9,120.11 |