- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $5,888.44 / $13,182.57
| Facility | | $489.78 | $5,888.44 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $4,786.30 / $9,120.11
| Facility | | $2,454.71 | $4,786.30 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $1,949.84
| Facility | | $575.44 | $575.44 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $389.05 / $389.05
| Professional | | $389.05 | $389.05 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $288.40 / $457.09
| Facility | | $181.97 | $288.40 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $11,220.18 / $16,982.44
| Facility | | $2,754.23 | $11,220.18 | $16,982.44 |