- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $64.57 / $14,454.40
| Facility | | $39.81 | $64.57 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,317.64 / $14,125.38
| Facility | | $5,011.87 | $8,317.64 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $95.50 / $151.36
| Facility | | $81.28 | $95.50 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $7,244.36 / $13,489.63
| Facility | | $39.81 | $7,244.36 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.15 / $13,489.63 / $26,302.68
| Facility | | $37.15 | $13,489.63 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $75.86 / $107.15
| Professional | | $47.86 | $75.86 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $1,288.25 / $1,288.25
| Facility | | $81.28 | $1,288.25 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $20,892.96 / $26,915.35
| Facility | | $10,964.78 | $20,892.96 | $26,915.35 |