- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $535.00 / $865.94 / $2,747.00
| Facility | | $535.00 | $865.94 | $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
- $544.32 / $774.45 / $893.38
| Facility | | $544.32 | $774.45 | $893.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,017.85 / $1,017.85 / $1,017.85
| Facility | | $1,017.85 | $1,017.85 | $1,017.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $739.00 / $2,396.50 / $8,582.00
| Facility | | $739.00 | $2,396.50 | $8,582.00 |