- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $576.45 / $920.06 / $7,212.00
| Facility | | $576.45 | $920.06 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,796.00 / $6,340.00 / $30,900.00
| Facility | | $2,796.00 | $6,340.00 | $30,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.59 / $846.45 / $1,185.03
| Facility | | $575.59 | $846.45 | $1,185.03 |
- 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
- $5,431.00 / $10,860.00 / $17,416.00
| Facility | | $5,431.00 | $10,860.00 | $17,416.00 |