- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $426.58 / $1,288.25
| Facility | | $323.59 | $426.58 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $331.13 / $537.03
| Professional | | $288.40 | $331.13 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $275.42 / $1,148.15
| Facility | | $275.42 | $275.42 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $524.81 / $616.60
| Professional | | $524.81 | $524.81 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $426.58 / $741.31
| Facility | | $316.23 | $426.58 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $177.83 / $1,621.81
| Professional | | $177.83 | $177.83 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $426.58 / $512.86
| Facility | | $177.83 | $426.58 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $177.83 / $281.84
| Professional | | $177.83 | $177.83 | $281.84 |