- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $309.03 / $14,454.40
| Facility | | $165.96 | $309.03 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $10,232.93 / $17,378.01
| Facility | | $4,677.35 | $10,232.93 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $457.09 / $724.44
| Facility | | $389.05 | $457.09 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $194.98 / $3,162.28
| Facility | | $147.91 | $194.98 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $208.93 / $5,248.07
| Facility | | $147.91 | $208.93 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $323.59 / $501.19
| Professional | | $177.83 | $323.59 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $16,218.10 / $23,988.33
| Facility | | $16,218.10 | $16,218.10 | $23,988.33 |
- 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 |