- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.03 / $3,777.80 / $5,177.00
| Facility | | $114.03 | $3,777.80 | $5,177.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $631.86 / $695.05 / $1,179.47
| Facility | | $631.86 | $695.05 | $1,179.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.44 / $530.00 / $975.74
| Facility | | $323.44 | $530.00 | $975.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.87 / $111.17 / $367.82
| Facility | | $70.87 | $111.17 | $367.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.00 / $650.00 / $4,824.00
| Facility | | $393.00 | $650.00 | $4,824.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $419.45 / $419.45 / $12,000.00
| Facility | | $419.45 | $419.45 | $12,000.00 |