- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $2,884.03 / $9,772.37
| Facility | | $436.52 | $2,884.03 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $954.99 / $1,862.09
| Facility | | $446.68 | $954.99 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $575.44 / $616.60
| Facility | | $263.03 | $575.44 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $398.11 / $630.96
| Professional | | $398.11 | $398.11 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $281.84 / $489.78
| Facility | | $162.18 | $281.84 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $3,890.45 / $7,762.47
| Facility | | $1,096.48 | $3,890.45 | $7,762.47 |