- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $204.17 / $6,760.83
| Facility | | $204.17 | $204.17 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.00 / $1,778.28 / $4,265.80
| Facility | | $1.00 | $1,778.28 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $562.34 / $1,348.96
| Facility | | $398.11 | $562.34 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $537.03 / $1,071.52
| Facility | | $436.52 | $537.03 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $323.59 / $1,445.44
| Facility | | $158.49 | $323.59 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,951.21 / $4,265.80
| Facility | | $1,584.89 | $2,951.21 | $4,265.80 |