- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.88 / $179.58 / $239.44
| Facility | | $161.88 | $179.58 | $239.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.08 / $238.08 / $238.08
| Facility | | $238.08 | $238.08 | $238.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.88 / $165.75 / $239.44
| Facility | | $161.88 | $165.75 | $239.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,198.44 / $4,332.21 / $4,445.76
| Facility | | $3,198.44 | $4,332.21 | $4,445.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.08 / $238.08 / $238.08
| Facility | | $238.08 | $238.08 | $238.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.56 / $204.56 / $247.73
| Facility | | $204.56 | $204.56 | $247.73 |