- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,582.00 / $3,055.00 / $7,960.15
| Facility | | $1,582.00 | $3,055.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $412.80 / $701.76 / $701.76
| Facility | | $412.80 | $701.76 | $701.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $333.00 / $1,722.50 / $1,894.75
| Facility | | $333.00 | $1,722.50 | $1,894.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.69 / $302.41 / $588.08
| Facility | | $212.69 | $302.41 | $588.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,226.00 / $6,302.00 / $14,767.00
| Facility | | $1,226.00 | $6,302.00 | $14,767.00 |