- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $5,495.41 / $9,772.37
| Facility | | $562.34 | $5,495.41 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $363.08 / $912.01
| Professional | | $288.40 | $363.08 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $524.81 / $758.58
| Professional | | $426.58 | $524.81 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $467.74 / $691.83
| Facility | | $323.59 | $467.74 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $436.52 / $8,709.64
| Facility | | $302.00 | $436.52 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $7,244.36 / $14,125.38
| Facility | | $3,801.89 | $7,244.36 | $14,125.38 |