- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $417.41 / $634.84 / $1,448.77
| Facility | | $417.41 | $634.84 | $1,448.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $336.47 / $417.41 / $444.39
| Professional | | $336.47 | $417.41 | $444.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $278.11 / $931.63 / $1,571.23
| Facility | | $278.11 | $931.63 | $1,571.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.76 / $611.60 / $1,506.72
| Professional | | $323.76 | $611.60 | $1,506.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $412.65 / $1,760.45 / $3,644.13
| Facility | | $412.65 | $1,760.45 | $3,644.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $730.07 / $1,156.68 / $1,568.05
| Professional | | $730.07 | $1,156.68 | $1,568.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.02 / $391.95 / $1,114.08
| Professional | | $292.02 | $391.95 | $1,114.08 |