- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $489.78 / $14,454.40
| Facility | | $245.47 | $489.78 | $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
- $616.60 / $724.44 / $1,148.15
| Facility | | $616.60 | $724.44 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $3,019.95 / $5,370.32
| Facility | | $263.03 | $3,019.95 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $5,248.07 / $8,317.64
| Facility | | $263.03 | $5,248.07 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $549.54 / $933.25
| Professional | | $281.84 | $549.54 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $5,495.41 / $5,495.41
| Facility | | $3,715.35 | $5,495.41 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $7,413.10 / $9,120.11
| Facility | | $4,897.79 | $7,413.10 | $9,120.11 |