- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $3,162.28 / $8,912.51
| Facility | | $263.03 | $3,162.28 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $229.09 / $467.74
| Professional | | $158.49 | $229.09 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $5,011.87 / $10,964.78
| Facility | | $1,737.80 | $5,011.87 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $239.88 / $446.68
| Professional | | $165.96 | $239.88 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $831.76 / $2,187.76
| Facility | | $281.84 | $831.76 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $269.15 / $549.54
| Professional | | $169.82 | $269.15 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $3,981.07 / $9,772.37
| Facility | | $1,047.13 | $3,981.07 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $229.09 / $416.87
| Professional | | $151.36 | $229.09 | $416.87 |