- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $567.02 / $787.00 / $3,740.00
| Facility | | $567.02 | $787.00 | $3,740.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.00 / $2,067.00 / $2,978.00
| Facility | | $1,041.00 | $2,067.00 | $2,978.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $608.20 / $857.05 / $988.67
| Facility | | $608.20 | $857.05 | $988.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $670.07 / $782.92 / $782.92
| Facility | | $670.07 | $782.92 | $782.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $2,723.00 / $6,295.00
| Facility | | $599.00 | $2,723.00 | $6,295.00 |