- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $422.33 / $604.16 / $2,747.00
| Facility | | $422.33 | $604.16 | $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
- $377.45 / $537.52 / $620.07
| Facility | | $377.45 | $537.52 | $620.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $584.73 / $706.45 / $706.45
| Facility | | $584.73 | $706.45 | $706.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $2,723.00 / $6,295.00
| Facility | | $599.00 | $2,723.00 | $6,295.00 |