- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $295.12 / $3,090.30
| Facility | | $158.49 | $295.12 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $758.58 / $1,230.27
| Facility | | $660.69 | $758.58 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $234.42 / $2,754.23
| Facility | | $138.04 | $234.42 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $239.88 / $5,623.41
| Facility | | $138.04 | $239.88 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $436.52 / $794.33
| Professional | | $229.09 | $436.52 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $7,943.28 / $7,943.28
| Facility | | $5,370.32 | $7,943.28 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $7,413.10 / $9,120.11
| Facility | | $4,897.79 | $7,413.10 | $9,120.11 |