- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $312.55 / $670.91 / $2,747.00
| Facility | | $312.55 | $670.91 | $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
- $342.39 / $488.14 / $563.10
| Facility | | $342.39 | $488.14 | $563.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $433.37 / $433.37 / $453.43
| Facility | | $433.37 | $433.37 | $453.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $2,723.00 / $6,295.00
| Facility | | $599.00 | $2,723.00 | $6,295.00 |