- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $229.09 / $14,454.40
| Facility | | $123.03 | $229.09 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $2,630.27 / $6,165.95
| Facility | | $2,041.74 | $2,630.27 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $331.13 / $524.81
| Facility | | $281.84 | $331.13 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $151.36 / $3,548.13
| Facility | | $109.65 | $151.36 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $158.49 / $4,786.30
| Facility | | $112.20 | $158.49 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $251.19 / $389.05
| Professional | | $134.90 | $251.19 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $2,818.38 / $4,265.80
| Facility | | $2,818.38 | $2,818.38 | $4,265.80 |
- 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 |