- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $4,897.79 / $8,912.51
| Facility | | $1,071.52 | $4,897.79 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57,543.99 / $64,565.42 / $70,794.58
| Facility | | $57,543.99 | $64,565.42 | $70,794.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $891.25 / $1,096.48 / $2,884.03
| Professional | | $891.25 | $1,096.48 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $851.14 / $1,071.52 / $2,041.74
| Professional | | $851.14 | $1,071.52 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $1,096.48 / $1,737.80
| Facility | | $851.14 | $1,096.48 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $1,148.15 / $29,512.09
| Facility | | $660.69 | $1,148.15 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $50,118.72 / $114,815.36
| Facility | | $22,908.68 | $50,118.72 | $114,815.36 |