- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $3,162.28 / $9,332.54
| Facility | | $501.19 | $3,162.28 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $91.20 / $229.09
| Professional | | $72.44 | $91.20 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $3,630.78 / $9,120.11
| Facility | | $1,513.56 | $3,630.78 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $123.03 / $229.09
| Professional | | $75.86 | $123.03 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $234.42 / $691.83
| Facility | | $138.04 | $234.42 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $147.91 / $316.23
| Professional | | $89.13 | $147.91 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $1,071.52 / $3,467.37
| Facility | | $239.88 | $1,071.52 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $120.23 / $208.93
| Professional | | $77.62 | $120.23 | $208.93 |