- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $206.44 / $306.98 / $715.88
| Facility | | $206.44 | $306.98 | $715.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $937.00 / $1,927.00 / $3,943.00
| Facility | | $937.00 | $1,927.00 | $3,943.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $196.26 / $235.51 / $291.49
| Facility | | $196.26 | $235.51 | $291.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,480.00 / $3,086.00 / $6,111.00
| Facility | | $1,480.00 | $3,086.00 | $6,111.00 |