- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $441.10 / $787.00 / $2,747.00
| Facility | | $441.10 | $787.00 | $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
- $483.36 / $689.61 / $795.51
| Facility | | $483.36 | $689.61 | $795.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $605.91 / $605.91 / $774.86
| Facility | | $605.91 | $605.91 | $774.86 |
- 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 |