- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $504.97 / $883.68 / $2,747.00
| Facility | | $504.97 | $883.68 | $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
- $544.08 / $765.76 / $883.35
| Facility | | $544.08 | $765.76 | $883.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $696.06 / $696.06 / $774.93
| Facility | | $696.06 | $696.06 | $774.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $739.00 / $2,396.50 / $8,582.00
| Facility | | $739.00 | $2,396.50 | $8,582.00 |