- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $667.98 / $1,243.00 / $10,695.20
| Facility | | $667.98 | $1,243.00 | $10,695.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,212.00 / $9,015.00 / $11,253.00
| Facility | | $7,212.00 | $9,015.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $720.62 / $1,023.25 / $1,180.39
| Facility | | $720.62 | $1,023.25 | $1,180.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $834.09 / $903.02 / $903.02
| Facility | | $834.09 | $903.02 | $903.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.00 / $4,539.00 / $10,113.00
| Facility | | $842.00 | $4,539.00 | $10,113.00 |