- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $192.51 / $442.34 / $16,467.00
| Facility | | $192.51 | $442.34 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,392.14 / $7,392.14 / $7,392.14
| Facility | | $7,392.14 | $7,392.14 | $7,392.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $535.00 / $570.00
| Facility | | $100.00 | $535.00 | $570.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $170.50 / $221.00 / $333.84
| Facility | | $170.50 | $221.00 | $333.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $1,138.00 / $3,585.00
| Facility | | $100.00 | $1,138.00 | $3,585.00 |