- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,630.27 / $6,606.93
| Facility | | $1,000.00 | $2,630.27 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $446.68 / $758.58
| Professional | | $363.08 | $446.68 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $512.86 / $707.95
| Professional | | $346.74 | $512.86 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $575.44 / $3,630.78
| Facility | | $407.38 | $575.44 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $478.63 / $3,090.30
| Professional | | $363.08 | $478.63 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $1,949.84 / $3,467.37
| Facility | | $524.81 | $1,949.84 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $426.58 / $645.65
| Professional | | $338.84 | $426.58 | $645.65 |