- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,445.44 / $2,398.83
| Facility | | $1,096.48 | $1,445.44 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $281.84 / $467.74
| Professional | | $162.18 | $281.84 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $309.03 / $416.87
| Facility | | $257.04 | $309.03 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $251.19 / $371.54
| Professional | | $190.55 | $251.19 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $309.03 / $309.03
| Facility | | $309.03 | $309.03 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $281.84 / $616.60
| Professional | | $177.83 | $281.84 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $562.34 / $1,548.82
| Facility | | $251.19 | $562.34 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $239.88 / $398.11
| Professional | | $147.91 | $239.88 | $398.11 |