- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.13 / $181.97 / $14,454.40
| Facility | | $74.13 | $181.97 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $12,589.25 / $16,218.10
| Facility | | $5,754.40 | $12,589.25 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $263.03 / $426.58
| Facility | | $229.09 | $263.03 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.10 / $2,570.40 / $4,786.30
| Facility | | $87.10 | $2,570.40 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.10 / $9,772.37 / $16,595.87
| Facility | | $87.10 | $9,772.37 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $208.93 / $288.40
| Professional | | $107.15 | $208.93 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $15,848.93 / $15,848.93
| Facility | | $10,471.29 | $15,848.93 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $13,489.63 / $17,378.01
| Facility | | $8,912.51 | $13,489.63 | $17,378.01 |