- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $347.82 / $514.77 / $1,113.02
| Facility | | $347.82 | $514.77 | $1,113.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $343.18 / $343.18 / $347.82
| Professional | | $343.18 | $343.18 | $347.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.44 / $301.44 / $1,238.92
| Facility | | $301.44 | $301.44 | $1,238.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $533.17 / $533.17 / $666.48
| Professional | | $533.17 | $533.17 | $666.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $278.26 / $371.01 / $1,553.60
| Facility | | $278.26 | $371.01 | $1,553.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.78 / $194.78 / $463.76
| Professional | | $194.78 | $194.78 | $463.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.78 / $194.78 / $278.26
| Professional | | $194.78 | $194.78 | $278.26 |