- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $630.96 / $14,454.40
| Facility | | $338.84 | $630.96 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $7,943.28 / $12,589.25
| Facility | | $5,011.87 | $7,943.28 | $12,589.25 |
- 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
- $295.12 / $426.58 / $8,709.64
| Facility | | $295.12 | $426.58 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $436.52 / $5,754.40
| Facility | | $309.03 | $436.52 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $691.83 / $1,071.52
| Professional | | $380.19 | $691.83 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,995.26 / $1,995.26
| Facility | | $794.33 | $1,995.26 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $6,165.95 / $19,498.45
| Facility | | $2,290.87 | $6,165.95 | $19,498.45 |