- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.93 / $129.65 / $5,634.00
| Facility | | $69.93 | $129.65 | $5,634.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $970.00 / $5,790.87 / $8,700.00
| Facility | | $970.00 | $5,790.87 | $8,700.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.96 / $70.04 / $135.36
| Facility | | $54.96 | $70.04 | $135.36 |
- 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 |