- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $126.80 / $126.80 / $5,618.00
| Facility | | $126.80 | $126.80 | $5,618.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $256.58 / $1,024.70 / $2,232.51
| Facility | | $256.58 | $1,024.70 | $2,232.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $279.63 / $396.55 / $953.96
| Facility | | $279.63 | $396.55 | $953.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $227.32 / $362.54 / $751.15
| Facility | | $227.32 | $362.54 | $751.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $201.51 / $381.53 / $3,500.00
| Facility | | $201.51 | $381.53 | $3,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,751.00 / $3,500.00 / $8,152.00
| Facility | | $1,751.00 | $3,500.00 | $8,152.00 |