- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $346.74 / $14,454.40
| Facility | | $186.21 | $346.74 | $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
- $436.52 / $512.86 / $812.83
| Facility | | $436.52 | $512.86 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $213.80 / $3,162.28
| Facility | | $162.18 | $213.80 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $229.09 / $4,897.79
| Facility | | $162.18 | $229.09 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $346.74 / $537.03
| Professional | | $190.55 | $346.74 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $3,311.31 / $4,897.79
| Facility | | $3,311.31 | $3,311.31 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,801.89 / $6,606.93
| Facility | | $2,884.03 | $3,801.89 | $6,606.93 |