- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $499.18 / $963.58 / $2,747.00
| Facility | | $499.18 | $963.58 | $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
- $534.74 / $751.34 / $866.72
| Facility | | $534.74 | $751.34 | $866.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $685.24 / $685.24 / $948.82
| Facility | | $685.24 | $685.24 | $948.82 |
- 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 |