- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $3,715.35 / $12,882.50
| Facility | | $977.24 | $3,715.35 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $323.59 / $3,090.30
| Facility | | $181.97 | $323.59 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $141.25 / $141.25
| Facility | | $141.25 | $141.25 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $1,995.26
| Facility | | $54.95 | $56.23 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $1,000.00 / $6,918.31
| Facility | | $165.96 | $1,000.00 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $204.17 / $407.38
| Facility | | $151.36 | $204.17 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $2,454.71 / $10,232.93
| Facility | | $436.52 | $2,454.71 | $10,232.93 |