- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $566.66 / $714.78 / $2,747.00
| Facility | | $566.66 | $714.78 | $2,747.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,830.00 / $8,584.00 / $11,253.00
| Facility | | $5,830.00 | $8,584.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $603.41 / $870.18 / $1,003.83
| Facility | | $603.41 | $870.18 | $1,003.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $765.17 / $765.17 / $765.17
| Facility | | $765.17 | $765.17 | $765.17 |
- 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 |