- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $478.63 / $14,454.40
| Facility | | $257.04 | $478.63 | $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
- $602.56 / $707.95 / $1,122.02
| Facility | | $602.56 | $707.95 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $331.13 / $3,467.37
| Facility | | $234.42 | $331.13 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $346.74 / $4,897.79
| Facility | | $234.42 | $346.74 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $501.19 / $776.25
| Professional | | $275.42 | $501.19 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,897.79 / $4,897.79
| Facility | | $3,311.31 | $4,897.79 | $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 |