- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.60 / $584.37 / $6,953.60
| Facility | | $373.60 | $584.37 | $6,953.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.71 / $515.00 / $35,600.00
| Facility | | $0.71 | $515.00 | $35,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.60 / $489.79 / $686.98
| Facility | | $373.60 | $489.79 | $686.98 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $96.10 / $119.20 / $139.82
| Facility | 80 | $96.10 | $119.20 | $139.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.00 / $661.00 / $4,877.00
| Facility | | $301.00 | $661.00 | $4,877.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $920.98 / $1,790.04
| Facility | | $55.00 | $920.98 | $1,790.04 |