- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $316.23 / $14,454.40
| Facility | | $169.82 | $316.23 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $7,762.47 / $12,589.25
| Facility | | $3,162.28 | $7,762.47 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $457.09 / $741.31
| Facility | | $398.11 | $457.09 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $223.87 / $3,467.37
| Facility | | $151.36 | $223.87 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $239.88 / $1,659.59
| Facility | | $158.49 | $239.88 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $338.84 / $524.81
| Professional | | $186.21 | $338.84 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $2,951.21 / $2,951.21
| Facility | | $398.11 | $2,951.21 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,584.89 / $1,949.84
| Facility | | $1,023.29 | $1,584.89 | $1,949.84 |