- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.48 / $691.76 / $2,747.00
| Facility | | $398.48 | $691.76 | $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
- $428.90 / $613.41 / $707.64
| Facility | | $428.90 | $613.41 | $707.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $541.71 / $541.71 / $637.15
| Facility | | $541.71 | $541.71 | $637.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $2,396.50 / $6,295.00
| Facility | | $599.00 | $2,396.50 | $6,295.00 |