- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.66 / $654.57 / $3,666.37
| Facility | | $140.66 | $654.57 | $3,666.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.00 / $2,067.00 / $2,978.00
| Facility | | $1,041.00 | $2,067.00 | $2,978.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $132.47 / $185.47 / $218.86
| Facility | | $132.47 | $185.47 | $218.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $142.09 / $161.44 / $161.44
| Facility | | $142.09 | $161.44 | $161.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $597.00 / $3,176.00
| Facility | | $50.00 | $597.00 | $3,176.00 |