- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $601.47 / $765.05 / $2,747.00
| Facility | | $601.47 | $765.05 | $2,747.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,643.00 / $3,498.00 / $8,517.00
| Facility | | $1,643.00 | $3,498.00 | $8,517.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $655.45 / $943.10 / $1,087.92
| Facility | | $655.45 | $943.10 | $1,087.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $592.26 / $828.03 / $828.03
| Facility | | $592.26 | $828.03 | $828.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $739.00 / $3,828.00 / $8,582.00
| Facility | | $739.00 | $3,828.00 | $8,582.00 |