- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $3,630.78 / $9,549.93
| Facility | | $263.03 | $3,630.78 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $5,248.07 / $7,079.46
| Facility | | $3,467.37 | $5,248.07 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $645.65 / $645.65
| Facility | | $645.65 | $645.65 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $281.84 / $331.13
| Professional | | $218.78 | $281.84 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $478.63 / $588.84
| Professional | | $389.05 | $478.63 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $346.74 / $562.34
| Facility | | $245.47 | $346.74 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $338.84 / $3,981.07
| Facility | | $239.88 | $338.84 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,388.44 / $7,079.46
| Facility | | $1,584.89 | $3,388.44 | $7,079.46 |