- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.14 / $602.17 / $7,212.00
| Facility | | $400.14 | $602.17 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,234.00 / $5,126.00 / $8,240.00
| Facility | | $2,234.00 | $5,126.00 | $8,240.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $329.69 / $480.22 / $688.66
| Facility | | $329.69 | $480.22 | $688.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,868.80 / $1,868.80 / $1,868.80
| Facility | | $1,868.80 | $1,868.80 | $1,868.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,364.00 / $6,094.00 / $10,413.00
| Facility | | $3,364.00 | $6,094.00 | $10,413.00 |