- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $570.21 / $1,924.00 / $9,128.46
| Facility | | $570.21 | $1,924.00 | $9,128.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,088.00 / $3,967.00 / $8,800.00
| Facility | | $2,088.00 | $3,967.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.19 / $725.72 / $837.16
| Facility | | $512.19 | $725.72 | $837.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.62 / $639.45 / $639.45
| Facility | | $616.62 | $639.45 | $639.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $973.00 / $4,639.00 / $12,296.00
| Facility | | $973.00 | $4,639.00 | $12,296.00 |