- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,318.26 / $14,454.40
| Facility | | $1,122.02 | $1,318.26 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $14,791.08 / $16,218.10
| Facility | | $6,456.54 | $14,791.08 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,041.74 / $3,019.95
| Facility | | $1,548.82 | $2,041.74 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $831.76 / $1,479.11
| Facility | | $602.56 | $831.76 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $10,232.93 / $17,378.01
| Facility | | $691.83 | $10,232.93 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,584.89 / $2,884.03
| Professional | | $1,071.52 | $1,584.89 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $7,585.78 / $7,585.78
| Facility | | $1,348.96 | $7,585.78 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $13,803.84 / $17,782.79
| Facility | | $8,912.51 | $13,803.84 | $17,782.79 |