- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $453.74 / $2,838.15 / $9,062.00
| Facility | | $453.74 | $2,838.15 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.94 / $345.88 / $616.63
| Facility | | $162.94 | $345.88 | $616.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.81 / $375.00 / $440.00
| Facility | | $308.81 | $375.00 | $440.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.25 / $217.96 / $338.58
| Facility | | $159.25 | $217.96 | $338.58 |
- 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 |