- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $655.36 / $1,518.54 / $7,909.08
| Facility | | $655.36 | $1,518.54 | $7,909.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,643.00 / $3,498.00 / $9,863.00
| Facility | | $1,643.00 | $3,498.00 | $9,863.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $582.69 / $834.09 / $962.18
| Facility | | $582.69 | $834.09 | $962.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $716.04 / $733.18 / $733.18
| Facility | | $716.04 | $733.18 | $733.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $973.00 / $4,639.00 / $12,296.00
| Facility | | $973.00 | $4,639.00 | $12,296.00 |