- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $346.74 / $14,454.40
| Facility | | $158.49 | $346.74 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,584.89 / $1,584.89
| Facility | | $1,202.26 | $1,584.89 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $512.86 / $812.83
| Facility | | $436.52 | $512.86 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $7,244.36 / $13,489.63
| Facility | | $181.97 | $7,244.36 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $1,202.26 / $1,778.28
| Facility | | $169.82 | $1,202.26 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $436.52 / $724.44
| Professional | | $223.87 | $436.52 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $1,288.25 / $1,288.25
| Facility | | $436.52 | $1,288.25 | $1,288.25 |
- 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 |