- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $265.31 / $2,588.50 / $7,293.93
| Facility | | $265.31 | $2,588.50 | $7,293.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.44 / $650.35 / $1,226.89
| Facility | | $323.44 | $650.35 | $1,226.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.47 / $287.00 / $417.16
| Facility | | $165.47 | $287.00 | $417.16 |
- 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
- $773.05 / $3,590.15 / $12,000.00
| Facility | | $773.05 | $3,590.15 | $12,000.00 |