- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $350.18 / $751.37 / $7,212.00
| Facility | | $350.18 | $751.37 | $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
- $343.80 / $446.94 / $607.42
| Facility | | $343.80 | $446.94 | $607.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $949.22 / $949.22 / $1,125.20
| Facility | | $949.22 | $949.22 | $1,125.20 |
- 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 |