- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $303.69 / $327.94 / $396.05
| Facility | | $303.69 | $327.94 | $396.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.64 / $327.94 / $395.18
| Professional | | $186.64 | $327.94 | $395.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,221.34 / $1,221.34 / $1,328.83
| Facility | | $1,221.34 | $1,221.34 | $1,328.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.74 / $302.52 / $387.86
| Professional | | $263.74 | $302.52 | $387.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $336.92 / $588.15 / $2,467.86
| Facility | | $336.92 | $588.15 | $2,467.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.90 / $360.34 / $499.31
| Professional | | $241.90 | $360.34 | $499.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $215.42 / $284.75 / $458.35
| Professional | | $215.42 | $284.75 | $458.35 |