- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $4,897.79 / $14,125.38
| Facility | | $346.74 | $4,897.79 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $309.03 / $660.69
| Professional | | $234.42 | $309.03 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $4,466.84 / $8,709.64
| Facility | | $2,454.71 | $4,466.84 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $354.81 / $549.54
| Professional | | $229.09 | $354.81 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $245.47 / $245.47
| Facility | | $245.47 | $245.47 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $354.81 / $426.58
| Facility | | $229.09 | $354.81 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $316.23 / $537.03
| Professional | | $239.88 | $316.23 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $2,818.38 / $4,265.80
| Facility | | $457.09 | $2,818.38 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $316.23 / $512.86
| Professional | | $239.88 | $316.23 | $512.86 |