- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $2,238.72 / $3,801.89
| Facility | | $302.00 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $524.81 / $2,754.23
| Facility | | $56.23 | $524.81 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $1,380.38 / $1,380.38
| Facility | | $1,380.38 | $1,380.38 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.20 / $190.55 / $7,079.46
| Facility | | $91.20 | $190.55 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $1,819.70 / $3,467.37
| Facility | | $229.09 | $1,819.70 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $524.81 / $2,754.23
| Facility | | $56.23 | $524.81 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $1,819.70 / $2,818.38
| Facility | | $309.03 | $1,819.70 | $2,818.38 |