- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $4,168.69 / $10,964.78
| Facility | | $478.63 | $4,168.69 | $10,964.78 |
- 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
- $234.42 / $288.40 / $724.44
| Professional | | $234.42 | $288.40 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $446.68 / $630.96
| Professional | | $354.81 | $446.68 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $363.08 / $575.44
| Facility | | $245.47 | $363.08 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $354.81 / $8,709.64
| Facility | | $251.19 | $354.81 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $7,244.36 / $14,125.38
| Facility | | $3,890.45 | $7,244.36 | $14,125.38 |