- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $7,244.36 / $16,595.87
| Facility | | $2,187.76 | $7,244.36 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $5,011.87 / $10,232.93
| Facility | | $933.25 | $5,011.87 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $588.84 / $3,311.31
| Facility | | $501.19 | $588.84 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $870.96 / $870.96 / $1,230.27
| Professional | | $870.96 | $870.96 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $1,071.52 / $1,698.24
| Facility | | $758.58 | $1,071.52 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $10,232.93 / $17,378.01
| Facility | | $933.25 | $10,232.93 | $17,378.01 |