- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $593.47 / $787.00 / $5,320.00
| Facility | | $593.47 | $787.00 | $5,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.00 / $2,316.00 / $4,389.00
| Facility | | $1,258.00 | $2,316.00 | $4,389.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $644.16 / $922.53 / $1,064.21
| Facility | | $644.16 | $922.53 | $1,064.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $755.39 / $813.53 / $813.53
| Facility | | $755.39 | $813.53 | $813.53 |
- 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 |