- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $213.80 / $363.08
| Facility | | $177.83 | $213.80 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $223.87 / $8,912.51
| Facility | | $223.87 | $223.87 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $21,877.62 / $51,286.14
| Facility | | $10,000.00 | $21,877.62 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $208.93 / $537.03
| Facility | | $158.49 | $208.93 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $50,118.72 / $75,857.76
| Facility | | $181.97 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,754.23 / $4,897.79
| Facility | | $1,318.26 | $2,754.23 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $213.80 / $602.56
| Facility | | $125.89 | $213.80 | $602.56 |