- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.23 / $5,000.27 / $7,838.38
| Facility | | $308.23 | $5,000.27 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $168.16 / $414.41 / $675.85
| Facility | | $168.16 | $414.41 | $675.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $259.45 / $259.45 / $259.45
| Facility | | $259.45 | $259.45 | $259.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $137.09 / $226.06 / $329.19
| Facility | | $137.09 | $226.06 | $329.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $200.00 / $1,158.00 / $1,327.00
| Facility | | $200.00 | $1,158.00 | $1,327.00 |