- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $416.87 / $14,454.40
| Facility | | $263.03 | $416.87 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,677.35 / $7,413.10
| Facility | | $2,630.27 | $4,677.35 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $616.60 / $977.24
| Facility | | $524.81 | $616.60 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $3,235.94 / $5,888.44
| Facility | | $239.88 | $3,235.94 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $3,388.44 / $9,549.93
| Facility | | $229.09 | $3,388.44 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $457.09 / $630.96
| Professional | | $281.84 | $457.09 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $524.81 / $1,621.81
| Facility | | $524.81 | $524.81 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $6,165.95 / $19,498.45
| Facility | | $2,290.87 | $6,165.95 | $19,498.45 |