- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.93 / $1,285.44 / $6,681.00
| Facility | | $131.93 | $1,285.44 | $6,681.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.00 / $145.00 / $623.00
| Facility | | $101.00 | $145.00 | $623.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.70 / $128.44 / $188.98
| Facility | | $95.70 | $128.44 | $188.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $363.57 / $363.57
| Facility | | $55.00 | $363.57 | $363.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $296.00 / $814.00 / $2,495.00
| Facility | | $296.00 | $814.00 | $2,495.00 |