- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $3,311.31 / $14,454.40
| Facility | | $1,548.82 | $3,311.31 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $10,232.93 / $18,197.01
| Facility | | $6,165.95 | $10,232.93 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $4,897.79 / $7,762.47
| Facility | | $4,168.69 | $4,897.79 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $6,760.83 / $13,489.63
| Facility | | $1,621.81 | $6,760.83 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $5,495.41 / $8,317.64
| Facility | | $1,621.81 | $5,495.41 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,905.46 / $3,715.35 / $5,623.41
| Professional | | $1,905.46 | $3,715.35 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $13,182.57 / $13,182.57
| Facility | | $4,168.69 | $13,182.57 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $7,413.10 / $9,120.11
| Facility | | $4,073.80 | $7,413.10 | $9,120.11 |