- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $1,230.27 / $6,165.95
| Facility | | $416.87 | $1,230.27 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,570.88 / $7,079.46
| Facility | | $2,630.27 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $1,819.70 / $2,951.21
| Facility | | $1,584.89 | $1,819.70 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $3,981.07 / $8,912.51
| Facility | | $501.19 | $3,981.07 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $3,019.95 / $6,165.95
| Facility | | $489.78 | $3,019.95 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.44 / $1,445.44 / $2,137.96
| Professional | | $724.44 | $1,445.44 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $3,801.89 / $5,623.41
| Facility | | $3,801.89 | $3,801.89 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,801.89 / $6,606.93
| Facility | | $2,884.03 | $3,801.89 | $6,606.93 |