- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.44 / $162.18 / $14,454.40
| Facility | | $72.44 | $162.18 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $4,786.30 / $7,413.10
| Facility | | $3,162.28 | $4,786.30 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $234.42 / $380.19
| Facility | | $204.17 | $234.42 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $6,918.31 / $13,489.63
| Facility | | $85.11 | $6,918.31 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $2,818.38 / $7,943.28
| Facility | | $85.11 | $2,818.38 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $199.53 / $338.84
| Professional | | $102.33 | $199.53 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $1,288.25 / $1,288.25
| Facility | | $204.17 | $1,288.25 | $1,288.25 |
- 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 |