- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $831.76 / $1,621.81
| Facility | | $575.44 | $831.76 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $380.19 / $575.44
| Professional | | $309.03 | $380.19 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $912.01 / $1,548.82
| Facility | | $562.34 | $912.01 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $354.81 / $645.65
| Professional | | $234.42 | $354.81 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $575.44 / $2,137.96
| Facility | | $380.19 | $575.44 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $524.81 / $831.76
| Professional | | $309.03 | $524.81 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $524.81 / $776.25
| Professional | | $275.42 | $524.81 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $346.74 / $1,023.29
| Professional | | $204.17 | $346.74 | $1,023.29 |