- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $616.60 / $14,454.40
| Facility | | $275.42 | $616.60 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $16,218.10 / $27,542.29
| Facility | | $11,748.98 | $16,218.10 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $891.25 / $1,412.54
| Facility | | $758.58 | $891.25 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $602.56 / $10,471.29
| Facility | | $288.40 | $602.56 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $616.60 / $7,585.78
| Facility | | $288.40 | $616.60 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $724.44 / $1,071.52
| Professional | | $467.74 | $724.44 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $1,995.26 / $1,995.26
| Facility | | $776.25 | $1,995.26 | $1,995.26 |
- 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 |