- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $1,548.82 / $3,981.07
| Facility | | $1,513.56 | $1,548.82 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $234.42 / $501.19
| Professional | | $154.88 | $234.42 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $186.21 / $346.74
| Professional | | $165.96 | $186.21 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $295.12 / $380.19
| Professional | | $194.98 | $295.12 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $1,412.54 / $6,456.54
| Facility | | $436.52 | $1,412.54 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $239.88 / $398.11
| Professional | | $162.18 | $239.88 | $398.11 |