- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $1,548.82 / $3,981.07
| Facility | | $1,513.56 | $1,548.82 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $416.87 / $660.69
| Professional | | $309.03 | $416.87 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $851.14 / $1,023.29
| Facility | | $549.54 | $851.14 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $416.87 / $645.65
| Professional | | $323.59 | $416.87 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $537.03 / $851.14
| Professional | | $371.54 | $537.03 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $1,412.54 / $6,456.54
| Facility | | $436.52 | $1,412.54 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $446.68 / $758.58
| Professional | | $331.13 | $446.68 | $758.58 |