- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.00 / $697.73 / $9,062.00
| Facility | | $87.00 | $697.73 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $567.00 / $2,070.54 / $3,825.20
| Facility | | $567.00 | $2,070.54 | $3,825.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $360.00 / $425.00 / $663.59
| Facility | | $360.00 | $425.00 | $663.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.00 / $130.50 / $473.46
| Facility | | $87.00 | $130.50 | $473.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $586.00 / $6,172.00 / $8,667.00
| Facility | | $586.00 | $6,172.00 | $8,667.00 |