- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $220.60 / $686.06 / $4,311.00
| Facility | | $220.60 | $686.06 | $4,311.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $567.09 / $623.79 / $1,058.57
| Facility | | $567.09 | $623.79 | $1,058.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.41 / $650.35 / $1,226.89
| Facility | | $338.41 | $650.35 | $1,226.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $220.60 / $525.62 / $775.06
| Facility | | $220.60 | $525.62 | $775.06 |
- 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
- $1,263.90 / $1,263.90 / $12,000.00
| Facility | | $1,263.90 | $1,263.90 | $12,000.00 |