- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $11,220.18 / $19,952.62
| Facility | | $1,348.96 | $11,220.18 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,754.40 / $10,715.19
| Facility | | $2,137.96 | $5,754.40 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $851.14 / $1,096.48
| Facility | | $707.95 | $851.14 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $1,174.90
| Professional | | $575.44 | $575.44 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $602.56 / $1,096.48
| Facility | | $457.09 | $602.56 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $11,220.18 / $16,982.44
| Facility | | $1,995.26 | $11,220.18 | $16,982.44 |