- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $7,762.47 / $8,709.64
| Facility | | $1,548.82 | $7,762.47 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $457.09 / $524.81
| Professional | | $371.54 | $457.09 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $60.26 / $85.11
| Professional | | $60.26 | $60.26 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $467.74 / $1,047.13
| Facility | | $467.74 | $467.74 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $21,379.62 / $36,307.81
| Facility | | $1,659.59 | $21,379.62 | $36,307.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $707.95 / $954.99
| Professional | | $537.03 | $707.95 | $954.99 |