- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $398.11 / $14,454.40
| Facility | | $213.80 | $398.11 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $7,762.47 / $12,589.25
| Facility | | $3,981.07 | $7,762.47 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $588.84 / $933.25
| Facility | | $501.19 | $588.84 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $251.19 / $3,162.28
| Facility | | $186.21 | $251.19 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $263.03 / $5,128.61
| Facility | | $186.21 | $263.03 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $407.38 / $630.96
| Professional | | $223.87 | $407.38 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $3,311.31 / $6,456.54
| Facility | | $3,311.31 | $3,311.31 | $6,456.54 |
- 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 |