- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $7,244.36 / $16,595.87
| Facility | | $660.69 | $7,244.36 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,981.07 / $7,585.78
| Facility | | $1,698.24 | $3,981.07 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $501.19 / $891.25
| Facility | | $398.11 | $501.19 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $457.09 / $549.54
| Professional | | $457.09 | $457.09 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $346.74 / $524.81
| Facility | | $234.42 | $346.74 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $1,202.26 / $3,548.13
| Facility | | $354.81 | $1,202.26 | $3,548.13 |