- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.61 / $388.12 / $2,170.67
| Facility | | $162.61 | $388.12 | $2,170.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.43 / $261.43 / $261.43
| Facility | | $261.43 | $261.43 | $261.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $201.32 / $265.43 / $298.24
| Facility | | $201.32 | $265.43 | $298.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $200.00 / $281.27 / $455.63
| Facility | | $200.00 | $281.27 | $455.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $317.66 / $354.04 / $823.14
| Facility | | $317.66 | $354.04 | $823.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $201.32 / $291.97 / $597.00
| Facility | | $201.32 | $291.97 | $597.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,079.00 / $2,826.00 / $4,851.00
| Facility | | $1,079.00 | $2,826.00 | $4,851.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.54 / $251.54 / $700.94
| Facility | | $251.54 | $251.54 | $700.94 |