- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $5,623.41 / $9,549.93
| Facility | | $4,365.16 | $5,623.41 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $3,162.28 / $6,760.83
| Facility | | $851.14 | $3,162.28 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $588.84 / $831.76
| Facility | | $199.53 | $588.84 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,162.28 / $4,073.80 / $8,128.31
| Professional | | $3,162.28 | $4,073.80 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- 80
- Low / Median / High Price
- $309.03 / $309.03 / $338.84
| Professional | 80 | $309.03 | $309.03 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $2,511.89 / $7,079.46
| Facility | | $398.11 | $2,511.89 | $7,079.46 |