- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.81 / $144.81 / $144.81
| Facility | | $144.81 | $144.81 | $144.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.26 / $609.02 / $38,732.54
| Facility | | $283.26 | $609.02 | $38,732.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $320.06 / $453.89 / $1,091.88
| Facility | | $320.06 | $453.89 | $1,091.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $260.19 / $414.96 / $859.75
| Facility | | $260.19 | $414.96 | $859.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $222.07 / $258.08 / $3,500.00
| Facility | | $222.07 | $258.08 | $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 |