- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $415.63 / $698.45 / $8,229.00
| Facility | | $415.63 | $698.45 | $8,229.00 |
- 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
- $459.31 / $657.30 / $758.25
| Facility | | $459.31 | $657.30 | $758.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.46 / $575.46 / $687.75
| Facility | | $575.46 | $575.46 | $687.75 |
- 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 |