- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $473.05 / $818.92 / $2,747.00
| Facility | | $473.05 | $818.92 | $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
- $506.61 / $713.89 / $823.52
| Facility | | $506.61 | $713.89 | $823.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $649.08 / $649.08 / $806.38
| Facility | | $649.08 | $649.08 | $806.38 |
- 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 |