- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $532.55 / $860.00 / $2,747.00
| Facility | | $532.55 | $860.00 | $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
- $573.38 / $808.74 / $932.94
| Facility | | $573.38 | $808.74 | $932.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $731.84 / $731.84 / $799.59
| Facility | | $731.84 | $731.84 | $799.59 |
- 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 |