- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $350.35 / $534.08 / $640.89
| Facility | | $350.35 | $534.08 | $640.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $320.45 / $350.35 / $363.17
| Professional | | $320.45 | $350.35 | $363.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $576.79 / $2,403.34 / $11,536.02
| Facility | | $576.79 | $2,403.34 | $11,536.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.71 / $576.79 / $119,998.80
| Professional | | $512.71 | $576.79 | $119,998.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $347.15 / $512.71 / $1,281.68
| Facility | | $347.15 | $512.71 | $1,281.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,059.39 / $2,059.39 / $2,059.39
| Professional | | $2,059.39 | $2,059.39 | $2,059.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $179.45 / $213.63 / $619.53
| Professional | | $179.45 | $213.63 | $619.53 |