- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $201.69 / $222.13 / $256.76
| Facility | | $201.69 | $222.13 | $256.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,014.00 / $8,584.00 / $11,253.00
| Facility | | $4,014.00 | $8,584.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $215.05 / $326.79 / $376.98
| Facility | | $215.05 | $326.79 | $376.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $287.58 / $287.58 / $287.58
| Facility | | $287.58 | $287.58 | $287.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.00 / $1,450.00 / $5,301.00
| Facility | | $523.00 | $1,450.00 | $5,301.00 |