- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $5,888.44 / $10,964.78
| Facility | | $2,691.53 | $5,888.44 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $354.81 / $2,398.83
| Professional | | $50.12 | $354.81 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $1,288.25 / $2,089.30
| Facility | | $870.96 | $1,288.25 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.67 / $43.65 / $75.86
| Professional | | $34.67 | $43.65 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $2,884.03 / $7,762.47
| Facility | | $1,380.38 | $2,884.03 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.74 / $89.13 / $162.18
| Professional | | $40.74 | $89.13 | $162.18 |