- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $529.38 / $3,232.00 / $9,833.92
| Facility | | $529.38 | $3,232.00 | $9,833.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $765.17 / $765.17 / $765.17
| Facility | | $765.17 | $765.17 | $765.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $596.00 / $1,266.00 / $1,266.00
| Facility | | $596.00 | $1,266.00 | $1,266.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.72 / $343.11 / $793.00
| Facility | | $239.72 | $343.11 | $793.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $816.00 / $2,081.00 / $3,918.00
| Facility | | $816.00 | $2,081.00 | $3,918.00 |