- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.83 / $832.53 / $7,212.00
| Facility | | $261.83 | $832.53 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $970.00 / $5,790.87 / $8,240.00
| Facility | | $970.00 | $5,790.87 | $8,240.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $206.93 / $263.73 / $304.31
| Facility | | $206.93 | $263.73 | $304.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $847.52 / $847.52 / $847.52
| Facility | | $847.52 | $847.52 | $847.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,638.00 / $2,854.00 / $4,271.00
| Facility | | $1,638.00 | $2,854.00 | $4,271.00 |