- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $2,238.72 / $10,715.19
| Facility | | $194.98 | $2,238.72 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,398.83 / $7,943.28
| Facility | | $954.99 | $2,398.83 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.72 / $109.65 / $1,096.48
| Facility | | $97.72 | $109.65 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $457.09 / $1,318.26
| Facility | | $173.78 | $457.09 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $457.09 / $1,778.28
| Facility | | $173.78 | $457.09 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $2,344.23
| Facility | | $100.00 | $100.00 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $2,398.83 / $5,248.07
| Facility | | $676.08 | $2,398.83 | $5,248.07 |