- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $609.38 / $769.44 / $2,747.00
| Facility | | $609.38 | $769.44 | $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
- $651.28 / $918.09 / $1,059.08
| Facility | | $651.28 | $918.09 | $1,059.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $757.64 / $835.49 / $835.49
| Facility | | $757.64 | $835.49 | $835.49 |
- 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 |