- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,290.87 / $6,918.31
| Facility | | $537.03 | $2,290.87 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $416.87 / $912.01
| Facility | | $218.78 | $416.87 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.95 / $100.00 / $100.00
| Facility | | $19.95 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.15 / $37.15 / $1,659.59
| Facility | | $37.15 | $37.15 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $323.59
| Facility | | $54.95 | $56.23 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.89 / $30.90 / $2,454.71
| Facility | | $20.89 | $30.90 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.42 / $27.54 / $47.86
| Facility | | $20.42 | $27.54 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $1,047.13 / $2,691.53
| Facility | | $151.36 | $1,047.13 | $2,691.53 |