- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $582.11 / $965.21 / $7,212.00
| Facility | | $582.11 | $965.21 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,943.00 / $5,126.00 / $8,240.00
| Facility | | $1,943.00 | $5,126.00 | $8,240.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $571.13 / $742.47 / $952.70
| Facility | | $571.13 | $742.47 | $952.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,868.80 / $1,868.80 / $2,215.28
| Facility | | $1,868.80 | $1,868.80 | $2,215.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,364.00 / $6,032.00 / $10,413.00
| Facility | | $3,364.00 | $6,032.00 | $10,413.00 |