- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $4,265.80 / $9,772.37
| Facility | | $263.03 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $407.38 / $691.83
| Facility | | $213.80 | $407.38 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $575.44 / $794.33
| Facility | | $371.54 | $575.44 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.58 / $758.58 / $1,148.15
| Professional | | $758.58 | $758.58 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $616.60 / $1,071.52
| Facility | | $457.09 | $616.60 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $1,202.26 / $3,548.13
| Facility | | $354.81 | $1,202.26 | $3,548.13 |