- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $542.25 / $900.11 / $5,634.00
| Facility | | $542.25 | $900.11 | $5,634.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,682.00 / $3,950.00 / $13,758.00
| Facility | | $1,682.00 | $3,950.00 | $13,758.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $543.26 / $746.69 / $1,118.48
| Facility | | $543.26 | $746.69 | $1,118.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,116.34 / $2,116.34 / $2,508.71
| Facility | | $2,116.34 | $2,116.34 | $2,508.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,462.00 / $3,782.00 / $5,402.00
| Facility | | $2,462.00 | $3,782.00 | $5,402.00 |