- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $268.70 / $272.52 / $1,660.33
| Professional | | $268.70 | $272.52 | $1,660.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $322.93 / $358.81 / $467.65
| Professional | | $322.93 | $358.81 | $467.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,267.40 / $1,267.40 / $1,267.40
| Facility | | $1,267.40 | $1,267.40 | $1,267.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.83 / $418.11 / $827.04
| Professional | | $292.83 | $418.11 | $827.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.98 / $429.38 / $713.88
| Professional | | $330.98 | $429.38 | $713.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $273.87 / $380.45 / $642.02
| Professional | | $273.87 | $380.45 | $642.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $297.10 / $382.78 / $472.41
| Professional | | $297.10 | $382.78 | $472.41 |