- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $557.21 / $1,354.00 / $8,220.83
| Facility | | $557.21 | $1,354.00 | $8,220.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,643.00 / $3,498.00 / $8,769.00
| Facility | | $1,643.00 | $3,498.00 | $8,769.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $609.70 / $869.27 / $1,002.76
| Facility | | $609.70 | $869.27 | $1,002.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $766.81 / $766.81 / $920.51
| Facility | | $766.81 | $766.81 | $920.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.00 / $4,539.00 / $10,113.00
| Facility | | $842.00 | $4,539.00 | $10,113.00 |