- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $484.31 / $852.46 / $2,747.00
| Facility | | $484.31 | $852.46 | $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
- $523.41 / $748.75 / $863.74
| Facility | | $523.41 | $748.75 | $863.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $658.40 / $658.40 / $839.40
| Facility | | $658.40 | $658.40 | $839.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $739.00 / $3,828.00 / $8,582.00
| Facility | | $739.00 | $3,828.00 | $8,582.00 |