- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.69 / $130.77 / $2,042.00
| Facility | | $68.69 | $130.77 | $2,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $342.30 / $1,462.23 / $3,247.99
| Facility | | $342.30 | $1,462.23 | $3,247.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $291.14 / $464.64 / $1,117.74
| Facility | | $291.14 | $464.64 | $1,117.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.92 / $409.66 / $880.11
| Facility | | $238.92 | $409.66 | $880.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.75 / $163.54 / $364.82
| Facility | | $77.75 | $163.54 | $364.82 |