- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $426.58 / $3,090.30
| Facility | | $229.09 | $426.58 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,090.30 / $5,754.40
| Facility | | $1,584.89 | $3,090.30 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $1,023.29 / $1,621.81
| Facility | | $870.96 | $1,023.29 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $338.84 / $2,754.23
| Facility | | $208.93 | $338.84 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $354.81 / $1,202.26
| Facility | | $213.80 | $354.81 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $645.65 / $1,122.02
| Professional | | $354.81 | $645.65 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $1,995.26 / $1,995.26
| Facility | | $537.03 | $1,995.26 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $1,584.89 / $1,949.84
| Facility | | $954.99 | $1,584.89 | $1,949.84 |