- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $362.54 / $602.08 / $3,670.53
| Facility | | $362.54 | $602.08 | $3,670.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $221.28 / $221.28 / $395.75
| Facility | | $221.28 | $221.28 | $395.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.37 / $585.53 / $925.02
| Facility | | $450.37 | $585.53 | $925.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.00 / $896.00 / $2,229.00
| Facility | | $117.00 | $896.00 | $2,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,161.19 / $2,415.85 / $12,000.00
| Facility | | $2,161.19 | $2,415.85 | $12,000.00 |