- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $341.85 / $787.00 / $2,747.00
| Facility | | $341.85 | $787.00 | $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
- $373.30 / $531.59 / $613.23
| Facility | | $373.30 | $531.59 | $613.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $470.94 / $470.94 / $581.08
| Facility | | $470.94 | $470.94 | $581.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.00 / $1,450.00 / $5,301.00
| Facility | | $523.00 | $1,450.00 | $5,301.00 |