- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $394.23 / $4,751.00 / $9,198.04
| Facility | | $394.23 | $4,751.00 | $9,198.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,759.45 / $3,523.62 / $6,158.44
| Facility | | $1,759.45 | $3,523.62 | $6,158.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $585.12 / $1,158.06
| Facility | | $580.00 | $585.12 | $1,158.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $388.22 / $626.00 / $1,052.30
| Facility | | $388.22 | $626.00 | $1,052.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.00 / $3,866.00 / $6,584.00
| Facility | | $490.00 | $3,866.00 | $6,584.00 |