- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.28 / $1,243.00 / $8,229.00
| Facility | | $594.28 | $1,243.00 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,104.00 / $5,018.00 / $12,101.00
| Facility | | $3,104.00 | $5,018.00 | $12,101.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.16 / $910.70 / $1,050.57
| Facility | | $641.16 | $910.70 | $1,050.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.55 / $806.78 / $806.78
| Facility | | $707.55 | $806.78 | $806.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $2,723.00 / $6,295.00
| Facility | | $599.00 | $2,723.00 | $6,295.00 |