- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $2,570.40 / $8,317.64
| Facility | | $131.83 | $2,570.40 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $501.19 / $616.60
| Facility | | $323.59 | $501.19 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $117.49 / $239.88
| Professional | | $97.72 | $117.49 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $199.53 / $263.03
| Professional | | $181.97 | $199.53 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $169.82 / $269.15
| Facility | | $114.82 | $169.82 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $165.96 / $562.34
| Facility | | $114.82 | $165.96 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $2,818.38 / $5,754.40
| Facility | | $512.86 | $2,818.38 | $5,754.40 |