- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.16 / $337.13 / $581.80
| Facility | | $213.16 | $337.13 | $581.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.16 / $218.18 / $268.33
| Professional | | $213.16 | $218.18 | $268.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.78 / $263.32 / $1,157.59
| Facility | | $250.78 | $263.32 | $1,157.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.08 / $152.97 / $439.62
| Professional | | $33.08 | $152.97 | $439.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.84 / $526.03 / $1,370.06
| Facility | | $8.84 | $526.03 | $1,370.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $238.73 / $288.27 / $366.77
| Professional | | $238.73 | $288.27 | $366.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $182.65 / $436.36 / $1,191.21
| Facility | | $182.65 | $436.36 | $1,191.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.33 / $127.40 / $298.66
| Professional | | $105.33 | $127.40 | $298.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.33 / $127.40 / $300.94
| Professional | | $105.33 | $127.40 | $300.94 |