- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.02 / $435.26 / $9,062.00
| Facility | | $103.02 | $435.26 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.88 / $336.76 / $536.66
| Facility | | $179.88 | $336.76 | $536.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $174.57 / $174.57 / $174.57
| Facility | | $174.57 | $174.57 | $174.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.76 / $186.51 / $312.24
| Facility | | $93.76 | $186.51 | $312.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $358.00 / $1,221.00 / $3,585.00
| Facility | | $358.00 | $1,221.00 | $3,585.00 |