- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $284.41 / $420.25 / $5,449.00
| Facility | | $284.41 | $420.25 | $5,449.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $221.28 / $221.28 / $606.10
| Facility | | $221.28 | $221.28 | $606.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $284.41 / $341.29 / $496.55
| Facility | | $284.41 | $341.29 | $496.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $182.66 / $874.00 / $2,074.00
| Facility | | $182.66 | $874.00 | $2,074.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,398.24 / $1,591.06
| Facility | | $55.00 | $1,398.24 | $1,591.06 |