- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $343.26 / $728.76 / $7,754.00
| Facility | | $343.26 | $728.76 | $7,754.00 |
- 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
- $368.74 / $532.15 / $613.87
| Facility | | $368.74 | $532.15 | $613.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $465.73 / $465.73 / $465.73
| Facility | | $465.73 | $465.73 | $465.73 |
- 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 |