- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $537.03 / $2,290.87
| Facility | | $158.49 | $537.03 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,897.79 / $7,585.78
| Facility | | $3,311.31 | $4,897.79 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $831.76 / $1,318.26
| Facility | | $707.95 | $831.76 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $338.84 / $3,548.13
| Facility | | $112.20 | $338.84 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.49 / $380.19 / $8,128.31
| Facility | | $117.49 | $380.19 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $371.54 / $912.01
| Professional | | $190.55 | $371.54 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $5,754.40 / $5,754.40
| Facility | | $3,981.07 | $5,754.40 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $3,235.94 / $3,235.94
| Facility | | $3,235.94 | $3,235.94 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $7,413.10 / $9,120.11
| Facility | | $4,897.79 | $7,413.10 | $9,120.11 |