- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.45 / $1,386.00 / $11,093.00
| Facility | | $512.45 | $1,386.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $970.00 / $5,230.00 / $8,240.00
| Facility | | $970.00 | $5,230.00 | $8,240.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $503.36 / $654.37 / $755.04
| Facility | | $503.36 | $654.37 | $755.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $949.22 / $949.22 / $1,125.20
| Facility | | $949.22 | $949.22 | $1,125.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,138.00 / $6,032.00 / $10,413.00
| Facility | | $3,138.00 | $6,032.00 | $10,413.00 |