- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $787.00 / $998.73 / $3,740.00
| Facility | | $787.00 | $998.73 | $3,740.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $343.21 / $1,036.13 / $11,253.00
| Facility | | $343.21 | $1,036.13 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $881.88 / $1,271.11 / $1,466.33
| Facility | | $881.88 | $1,271.11 | $1,466.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,058.90 / $1,112.59 / $1,112.59
| Facility | | $1,058.90 | $1,112.59 | $1,112.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $668.00 / $3,176.00
| Facility | | $50.00 | $668.00 | $3,176.00 |