- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $4,168.69 / $10,715.19
| Facility | | $512.86 | $4,168.69 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $323.59 / $831.76
| Professional | | $245.47 | $323.59 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $5,128.61 / $12,022.64
| Facility | | $1,819.70 | $5,128.61 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $380.19 / $724.44
| Professional | | $234.42 | $380.19 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $831.76 / $1,862.09
| Facility | | $426.58 | $831.76 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $416.87 / $870.96
| Professional | | $263.03 | $416.87 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $4,168.69 / $9,549.93
| Facility | | $1,513.56 | $4,168.69 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $338.84 / $616.60
| Professional | | $234.42 | $338.84 | $616.60 |