- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $426.58 / $426.58
| Facility | | $426.58 | $426.58 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $416.87 / $630.96
| Professional | | $316.23 | $416.87 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218,776.16 / $524,807.46 / $954,992.59
| Facility | | $218,776.16 | $524,807.46 | $954,992.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $660.69 / $870.96
| Professional | | $660.69 | $660.69 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $630.96
| Facility | | $575.44 | $575.44 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $416.87 / $575.44
| Professional | | $323.59 | $416.87 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $891.25 / $1,047.13
| Facility | | $407.38 | $891.25 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $380.19 / $588.84
| Professional | | $257.04 | $380.19 | $588.84 |