- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.74 / $218.78 / $4,897.79
| Facility | | $40.74 | $218.78 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $34.67 / $67.61
| Facility | | $34.67 | $34.67 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $36.31 / $41.69
| Facility | | $34.67 | $36.31 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $147.91 / $302.00
| Facility | | $44.67 | $147.91 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $2,238.72 / $7,413.10
| Facility | | $602.56 | $2,238.72 | $7,413.10 |