- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $681.41 / $941.63 / $2,747.00
| Facility | | $681.41 | $941.63 | $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
- $732.80 / $1,063.55 / $1,226.89
| Facility | | $732.80 | $1,063.55 | $1,226.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $925.87 / $925.87 / $927.20
| Facility | | $925.87 | $925.87 | $927.20 |
- 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 |