- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.66 / $915.95 / $9,062.00
| Facility | | $250.66 | $915.95 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.54 / $916.02 / $2,256.40
| Facility | | $471.54 | $916.02 | $2,256.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $569.33 / $663.59
| Facility | | $375.00 | $569.33 | $663.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.49 / $783.39 / $1,265.77
| Facility | | $103.49 | $783.39 | $1,265.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $586.00 / $6,172.00 / $8,667.00
| Facility | | $586.00 | $6,172.00 | $8,667.00 |