- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $294.27 / $645.91 / $1,288.60
| Facility | | $294.27 | $645.91 | $1,288.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $216.38 / $259.66 / $2,076.63
| Professional | | $216.38 | $259.66 | $2,076.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.66 / $805.10 / $1,339.01
| Facility | | $204.66 | $805.10 | $1,339.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $211.91 / $308.23 / $439.23
| Professional | | $211.91 | $308.23 | $439.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.27 / $524.79 / $944.64
| Facility | | $212.27 | $524.79 | $944.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $217.12 / $370.87 / $491.99
| Professional | | $217.12 | $370.87 | $491.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $171.17 / $238.02 / $1,534.06
| Facility | | $171.17 | $238.02 | $1,534.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.63 / $186.45 / $285.45
| Professional | | $135.63 | $186.45 | $285.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.63 / $186.45 / $285.45
| Professional | | $135.63 | $186.45 | $285.45 |