- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $6,456.54 / $16,982.44
| Facility | | $2,398.83 | $6,456.54 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $4,466.84 / $12,882.50
| Facility | | $2,511.89 | $4,466.84 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $2,570.40 / $7,762.47
| Facility | | $66.07 | $2,570.40 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $2,089.30 / $2,454.71
| Facility | | $2,089.30 | $2,089.30 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.51 / $44.67 / $77.62
| Professional | | $29.51 | $44.67 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.70 / $69.18 / $128.82
| Professional | | $53.70 | $69.18 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $28,840.32 / $28,840.32
| Facility | | $9,332.54 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $87.10 / $144.54
| Facility | | $66.07 | $87.10 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $4,365.16 / $9,772.37
| Facility | | $2,290.87 | $4,365.16 | $9,772.37 |