- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $533.91 / $1,169.68 / $9,062.00
| Facility | | $533.91 | $1,169.68 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.64 / $438.34 / $711.67
| Facility | | $208.64 | $438.34 | $711.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $580.00 / $1,370.63
| Facility | | $375.00 | $580.00 | $1,370.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $440.81 / $581.79 / $941.78
| Facility | | $440.81 | $581.79 | $941.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.00 / $1,221.00 / $3,585.00
| Facility | | $225.00 | $1,221.00 | $3,585.00 |