- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,582.00 / $2,933.00 / $7,562.14
| Facility | | $1,582.00 | $2,933.00 | $7,562.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.20 / $314.52 / $518.16
| Facility | | $79.20 | $314.52 | $518.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $207.63 / $207.63 / $207.63
| Facility | | $207.63 | $207.63 | $207.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $132.84 / $558.01 / $1,114.11
| Facility | | $132.84 | $558.01 | $1,114.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $716.00 / $1,535.00 / $2,175.00
| Facility | | $716.00 | $1,535.00 | $2,175.00 |