- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $537.03 / $7,943.28
| Facility | | $213.80 | $537.03 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $831.76 / $1,318.26
| Facility | | $707.95 | $831.76 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $436.52 / $3,715.35
| Facility | | $229.09 | $436.52 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $537.03 / $8,317.64
| Facility | | $213.80 | $537.03 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $512.86 / $851.14
| Professional | | $295.12 | $512.86 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $9,549.93 / $9,549.93
| Facility | | $6,456.54 | $9,549.93 | $9,549.93 |
- 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 |