- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $317.19 / $375.06 / $552.51
| Facility | | $317.19 | $375.06 | $552.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $282.52 / $371.69 / $424.38
| Professional | | $282.52 | $371.69 | $424.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,070.02 / $1,451.01 / $2,101.81
| Facility | | $1,070.02 | $1,451.01 | $2,101.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $370.49 / $370.49 / $470.33
| Facility | | $370.49 | $370.49 | $470.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $324.08 / $374.49 / $511.15
| Professional | | $324.08 | $374.49 | $511.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.88 / $500.71 / $2,752.41
| Facility | | $316.88 | $500.71 | $2,752.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.86 / $431.65 / $1,025.25
| Professional | | $309.86 | $431.65 | $1,025.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.86 / $402.52 / $847.82
| Professional | | $309.86 | $402.52 | $847.82 |