- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $1,445.44 / $7,585.78
| Facility | | $309.03 | $1,445.44 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $346.74 / $794.33
| Professional | | $281.84 | $346.74 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $141.25 / $141.25
| Facility | | $141.25 | $141.25 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $338.84 / $602.56
| Professional | | $269.15 | $338.84 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $602.56 / $1,230.27
| Facility | | $537.03 | $602.56 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $660.69 / $2,511.89
| Professional | | $354.81 | $660.69 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $144.54 / $501.19
| Facility | | $144.54 | $144.54 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $338.84 / $562.34
| Professional | | $257.04 | $338.84 | $562.34 |