- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.00 / $576.57 / $4,838.03
| Facility | | $138.00 | $576.57 | $4,838.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $949.00 / $3,896.00 / $8,230.00
| Facility | | $949.00 | $3,896.00 | $8,230.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $127.08 / $165.20 / $190.62
| Facility | | $127.08 | $165.20 | $190.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $166.36 / $166.36 / $166.36
| Facility | | $166.36 | $166.36 | $166.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $600.00 / $2,291.00 / $4,426.00
| Facility | | $600.00 | $2,291.00 | $4,426.00 |