- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $457.09 / $14,454.40
| Facility | | $269.15 | $457.09 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $12,882.50 / $21,877.62
| Facility | | $7,585.78 | $12,882.50 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $660.69 / $1,071.52
| Facility | | $562.34 | $660.69 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $2,884.03 / $5,370.32
| Facility | | $269.15 | $2,884.03 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $6,918.31 / $13,803.84
| Facility | | $257.04 | $6,918.31 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $501.19 / $870.96
| Professional | | $257.04 | $501.19 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $13,803.84 / $13,803.84
| Facility | | $9,332.54 | $13,803.84 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,232.93 / $14,454.40
| Facility | | $6,606.93 | $10,232.93 | $14,454.40 |