- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $317.04 / $988.00 / $3,740.00
| Facility | | $317.04 | $988.00 | $3,740.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,584.00 / $10,099.00 / $11,253.00
| Facility | | $8,584.00 | $10,099.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $303.62 / $416.74 / $480.74
| Facility | | $303.62 | $416.74 | $480.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $431.27 / $547.71 / $547.71
| Facility | | $431.27 | $547.71 | $547.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $597.00 / $3,176.00
| Facility | | $50.00 | $597.00 | $3,176.00 |