- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.76 / $721.77 / $5,390.45
| Facility | | $250.76 | $721.77 | $5,390.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $606.10
| Facility | | $606.10 | $606.10 | $606.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.76 / $558.08 / $828.97
| Facility | | $250.76 | $558.08 | $828.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $3,733.00 / $6,543.00
| Facility | | $900.00 | $3,733.00 | $6,543.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,450.25 / $1,450.25
| Facility | | $55.00 | $1,450.25 | $1,450.25 |