- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $19,054.61 / $60,255.96
| Facility | | $2,238.72 | $19,054.61 | $60,255.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,621.81 / $2,137.96 / $2,818.38
| Professional | | $1,621.81 | $2,137.96 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,089.30 / $20,417.38
| Facility | | $1,318.26 | $2,089.30 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $2,187.76 / $2,344.23
| Facility | | $1,698.24 | $2,187.76 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,548.82 / $2,691.53
| Facility | | $1,096.48 | $1,548.82 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $42,657.95 / $69,183.10
| Facility | | $17,782.79 | $42,657.95 | $69,183.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $26,302.68 / $79,432.82
| Facility | | $3,311.31 | $26,302.68 | $79,432.82 |