- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $288.40 / $14,454.40
| Facility | | $257.04 | $288.40 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $6,165.95 / $7,585.78
| Facility | | $4,168.69 | $6,165.95 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $478.63 / $758.58
| Facility | | $407.38 | $478.63 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $1,584.89 / $6,918.31
| Facility | | $158.49 | $1,584.89 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $912.01 / $1,778.28
| Facility | | $147.91 | $912.01 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $239.88 / $549.54
| Professional | | $112.20 | $239.88 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $2,511.89 / $2,511.89
| Facility | | $323.59 | $2,511.89 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,584.89 / $2,137.96
| Facility | | $1,023.29 | $1,584.89 | $2,137.96 |