- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $3,630.78 / $8,912.51
| Facility | | $389.05 | $3,630.78 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $6,760.83 / $7,413.10
| Facility | | $5,888.44 | $6,760.83 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $524.81 / $616.60
| Facility | | $489.78 | $524.81 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $346.74 / $707.95
| Professional | | $288.40 | $346.74 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $758.58 / $812.83
| Professional | | $660.69 | $758.58 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $489.78 / $851.14
| Facility | | $331.13 | $489.78 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $501.19 / $1,621.81
| Facility | | $338.84 | $501.19 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $8,317.64 / $17,378.01
| Facility | | $1,318.26 | $8,317.64 | $17,378.01 |