- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.86 / $141.25 / $1,905.46
| Facility | | $75.86 | $141.25 | $1,905.46 |
- 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
- $295.12 / $338.84 / $549.54
| Facility | | $295.12 | $338.84 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.18 / $251.19 / $3,801.89
| Facility | | $69.18 | $251.19 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $1,949.84 / $4,168.69
| Facility | | $66.07 | $1,949.84 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $218.78 / $389.05
| Professional | | $120.23 | $218.78 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $3,548.13 / $3,548.13
| Facility | | $2,454.71 | $3,548.13 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,884.03 / $5,011.87
| Facility | | $2,344.23 | $2,884.03 | $5,011.87 |