- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $394.80 / $642.37 / $8,067.26
| Facility | | $394.80 | $642.37 | $8,067.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,643.00 / $3,498.00 / $8,517.00
| Facility | | $1,643.00 | $3,498.00 | $8,517.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $377.03 / $517.48 / $596.96
| Facility | | $377.03 | $517.48 | $596.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $680.12 / $680.12 / $680.12
| Facility | | $680.12 | $680.12 | $680.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.00 / $945.00 / $6,295.00
| Facility | | $575.00 | $945.00 | $6,295.00 |