- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $139.65 / $417.98 / $9,062.00
| Facility | | $139.65 | $417.98 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.94 / $337.35 / $796.00
| Facility | | $162.94 | $337.35 | $796.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $259.45 / $505.00 / $570.00
| Facility | | $259.45 | $505.00 | $570.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.38 / $261.87 / $487.62
| Facility | | $161.38 | $261.87 | $487.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $1,138.00 / $3,585.00
| Facility | | $100.00 | $1,138.00 | $3,585.00 |