- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $162.18 / $14,454.40
| Facility | | $66.07 | $162.18 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $3,019.95 / $5,754.40
| Facility | | $2,089.30 | $3,019.95 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $234.42 / $380.19
| Facility | | $204.17 | $234.42 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.44 / $234.42 / $4,265.80
| Facility | | $72.44 | $234.42 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $239.88 / $5,623.41
| Facility | | $77.62 | $239.88 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $173.78 / $257.04
| Professional | | $117.49 | $173.78 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $1,288.25 / $1,288.25
| Facility | | $204.17 | $1,288.25 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $3,630.78 / $6,456.54
| Facility | | $2,754.23 | $3,630.78 | $6,456.54 |