- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $381.64 / $463.46 / $840.39
| Professional | | $381.64 | $463.46 | $840.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $228.98 / $827.20 / $1,495.55
| Facility | | $228.98 | $827.20 | $1,495.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $572.45 / $763.27 / $1,039.96
| Professional | | $572.45 | $763.27 | $1,039.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $499.17 / $499.17 / $499.17
| Facility | | $499.17 | $499.17 | $499.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.39 / $364.39 / $894.75
| Professional | | $364.39 | $364.39 | $894.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $248.53 / $664.92 / $4,299.75
| Facility | | $248.53 | $664.92 | $4,299.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $347.59 / $384.97 / $579.90
| Professional | | $347.59 | $384.97 | $579.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $347.94 / $384.97 / $579.90
| Professional | | $347.94 | $384.97 | $579.90 |