- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $4,570.88 / $11,220.18
| Facility | | $436.52 | $4,570.88 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $323.59 / $616.60
| Professional | | $239.88 | $323.59 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $4,677.35 / $10,471.29
| Facility | | $1,819.70 | $4,677.35 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $346.74 / $645.65
| Professional | | $234.42 | $346.74 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $812.83 / $2,290.87
| Facility | | $169.82 | $812.83 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $389.05 / $870.96
| Professional | | $239.88 | $389.05 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,862.09 / $4,677.35
| Facility | | $467.74 | $1,862.09 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $316.23 / $588.84
| Professional | | $223.87 | $316.23 | $588.84 |