- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $6,025.60 / $16,982.44
| Facility | | $1,778.28 | $6,025.60 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $4,570.88 / $12,882.50
| Facility | | $2,570.40 | $4,570.88 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $1,995.26 / $7,079.46
| Facility | | $66.07 | $1,995.26 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $3,890.45 / $4,570.88
| Facility | | $3,890.45 | $3,890.45 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $467.74 / $851.14
| Professional | | $354.81 | $467.74 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $724.44 / $1,380.38
| Professional | | $549.54 | $724.44 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $19,498.45 / $19,498.45
| Facility | | $17,378.01 | $19,498.45 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $724.44 / $1,122.02
| Facility | | $524.81 | $724.44 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $4,365.16 / $9,772.37
| Facility | | $2,344.23 | $4,365.16 | $9,772.37 |