- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $531.46 / $787.00 / $3,740.00
| Facility | | $531.46 | $787.00 | $3,740.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.00 / $2,067.00 / $2,978.00
| Facility | | $1,041.00 | $2,067.00 | $2,978.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $570.34 / $805.64 / $929.37
| Facility | | $570.34 | $805.64 | $929.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $731.84 / $731.84 / $768.46
| Facility | | $731.84 | $731.84 | $768.46 |
- 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 |