- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $616.60 / $14,454.40
| Facility | | $331.13 | $616.60 | $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
- $776.25 / $912.01 / $1,445.44
| Facility | | $776.25 | $912.01 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $398.11 / $3,548.13
| Facility | | $288.40 | $398.11 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $416.87 / $4,786.30
| Facility | | $295.12 | $416.87 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $630.96 / $977.24
| Professional | | $346.74 | $630.96 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $3,630.78 / $3,630.78
| Facility | | $2,454.71 | $3,630.78 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,630.78 / $6,456.54
| Facility | | $2,884.03 | $3,630.78 | $6,456.54 |