- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.80 / $834.00 / $11,093.00
| Facility | | $323.80 | $834.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.00 / $6,474.00 / $13,758.00
| Facility | | $2,318.00 | $6,474.00 | $13,758.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $320.26 / $416.34 / $628.36
| Facility | | $320.26 | $416.34 | $628.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,705.12 / $4,705.12 / $5,577.46
| Facility | | $4,705.12 | $4,705.12 | $5,577.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,138.00 / $6,032.00 / $10,413.00
| Facility | | $3,138.00 | $6,032.00 | $10,413.00 |