- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $274.61 / $3,908.01 / $13,841.56
| Facility | | $274.61 | $3,908.01 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,350.61 / $4,406.97 / $8,524.51
| Facility | | $3,350.61 | $4,406.97 | $8,524.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.40 / $193.40 / $193.40
| Facility | | $193.40 | $193.40 | $193.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $273.07 / $468.70 / $598.75
| Facility | | $273.07 | $468.70 | $598.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $207.58 / $588.82 / $839.11
| Facility | | $207.58 | $588.82 | $839.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $198.02 / $355.12 / $4,317.00
| Facility | | $198.02 | $355.12 | $4,317.00 |