- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $141.25 / $14,454.40
| Facility | | $79.43 | $141.25 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,570.88 / $7,079.46
| Facility | | $2,630.27 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $199.53 / $316.23
| Facility | | $169.82 | $199.53 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $3,162.28 / $5,888.44
| Facility | | $79.43 | $3,162.28 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.86 / $3,548.13 / $6,165.95
| Facility | | $75.86 | $3,548.13 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $169.82 / $251.19
| Professional | | $93.33 | $169.82 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $3,019.95 / $4,466.84
| Facility | | $3,019.95 | $3,019.95 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,801.89 / $6,456.54
| Facility | | $2,884.03 | $3,801.89 | $6,456.54 |