- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $346.74 / $14,454.40
| Facility | | $186.21 | $346.74 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $512.86 / $831.76
| Facility | | $446.68 | $512.86 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $208.93 / $2,818.38
| Facility | | $151.36 | $208.93 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $218.78 / $4,365.16
| Facility | | $154.88 | $218.78 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $398.11 / $616.60
| Professional | | $218.78 | $398.11 | $616.60 |
- 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 |