- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $565.36 / $987.01 / $2,747.00
| Facility | | $565.36 | $987.01 | $2,747.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,643.00 / $3,498.00 / $8,769.00
| Facility | | $1,643.00 | $3,498.00 | $8,769.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $612.72 / $877.48 / $1,012.23
| Facility | | $612.72 | $877.48 | $1,012.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $771.87 / $771.87 / $1,111.54
| Facility | | $771.87 | $771.87 | $1,111.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.00 / $4,539.00 / $10,113.00
| Facility | | $842.00 | $4,539.00 | $10,113.00 |