- 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 / $275.42 / $478.63
| Professional | | $162.18 | $275.42 | $478.63 |
- 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
- $199.53 / $269.15 / $426.58
| Professional | | $199.53 | $269.15 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $316.23 / $316.23
| Facility | | $316.23 | $316.23 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $263.03 / $602.56
| Professional | | $177.83 | $263.03 | $602.56 |
- 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
- $151.36 / $251.19 / $426.58
| Professional | | $151.36 | $251.19 | $426.58 |