- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $182.14 / $1,390.50 / $7,796.00
| Facility | | $182.14 | $1,390.50 | $7,796.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $520.00 / $1,180.40 / $2,213.48
| Facility | | $520.00 | $1,180.40 | $2,213.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $360.00 / $440.00 / $645.24
| Facility | | $360.00 | $440.00 | $645.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.47 / $249.00 / $450.93
| Facility | | $78.47 | $249.00 | $450.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.00 / $3,682.00 / $6,584.00
| Facility | | $438.00 | $3,682.00 | $6,584.00 |