- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $281.84 / $14,454.40
| Facility | | $257.04 | $281.84 | $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 / $467.74 / $758.58
| Facility | | $407.38 | $467.74 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $1,584.89 / $6,918.31
| Facility | | $154.88 | $1,584.89 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $912.01 / $1,778.28
| Facility | | $144.54 | $912.01 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $234.42 / $537.03
| Professional | | $109.65 | $234.42 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $2,137.96 / $2,137.96
| Facility | | $323.59 | $2,137.96 | $2,137.96 |
- 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 |