- 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
- $97.72 / $234.42 / $363.08
| Professional | | $97.72 | $234.42 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $169.82 / $281.84
| Professional | | $87.10 | $169.82 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $204.17 / $457.09
| Professional | | $81.28 | $204.17 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $4,073.80 / $6,165.95
| Facility | | $1,819.70 | $4,073.80 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $169.82 / $346.74
| Professional | | $75.86 | $169.82 | $346.74 |