- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.81 / $138.78 / $2,042.00
| Facility | | $86.81 | $138.78 | $2,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $423.80 / $1,554.06 / $3,239.20
| Facility | | $423.80 | $1,554.06 | $3,239.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $340.94 / $483.75 / $1,163.72
| Facility | | $340.94 | $483.75 | $1,163.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $294.25 / $442.26 / $916.31
| Facility | | $294.25 | $442.26 | $916.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.77 / $199.78 / $416.32
| Facility | | $110.77 | $199.78 | $416.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,187.00 / $2,872.00 / $4,241.00
| Facility | | $1,187.00 | $2,872.00 | $4,241.00 |