- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $7,585.78 / $18,197.01
| Facility | | $3,019.95 | $7,585.78 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $7,943.28 / $15,848.93
| Facility | | $4,570.88 | $7,943.28 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $1,288.25 / $8,709.64
| Facility | | $66.07 | $1,288.25 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $851.14 / $2,344.23
| Facility | | $575.44 | $851.14 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $501.19 / $794.33
| Professional | | $426.58 | $501.19 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $467.74 / $891.25
| Professional | | $363.08 | $467.74 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $45,708.82 / $45,708.82
| Facility | | $6,918.31 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $562.34 / $912.01
| Facility | | $407.38 | $562.34 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,265.80 / $9,549.93
| Facility | | $2,238.72 | $4,265.80 | $9,549.93 |