- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $335.89 / $476.58 / $1,146.48
| Facility | | $335.89 | $476.58 | $1,146.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.75 / $283.43 / $549.14
| Professional | | $144.75 | $283.43 | $549.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $273.20 / $435.71 / $902.74
| Facility | | $273.20 | $435.71 | $902.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.32 / $258.45 / $461.00
| Professional | | $143.32 | $258.45 | $461.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.33 / $148.08 / $213.55
| Facility | | $57.33 | $148.08 | $213.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $347.00 / $1,367.00 / $1,367.00
| Professional | | $347.00 | $1,367.00 | $1,367.00 |