- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $6,606.93 / $16,982.44
| Facility | | $2,454.71 | $6,606.93 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $4,466.84 / $12,882.50
| Facility | | $2,570.40 | $4,466.84 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.57 / $1,621.81 / $7,943.28
| Facility | | $64.57 | $1,621.81 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $229.09 / $295.12
| Professional | | $218.78 | $229.09 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $245.47 / $501.19
| Professional | | $186.21 | $245.47 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,090.30 / $28,840.32
| Facility | | $3,090.30 | $3,090.30 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $302.00 / $512.86
| Facility | | $223.87 | $302.00 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $1,584.89 / $6,456.54
| Facility | | $588.84 | $1,584.89 | $6,456.54 |