- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,145.78 / $7,838.38
| Facility | | $1,000.00 | $2,145.78 | $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
- $182.82 / $182.82 / $323.47
| Facility | | $182.82 | $182.82 | $323.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.99 / $198.00 / $247.95
| Facility | | $153.99 | $198.00 | $247.95 |
- 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 |