- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $680.22 / $3,383.99 / $16,985.38
| Facility | | $680.22 | $3,383.99 | $16,985.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,641.00 / $10,700.00 / $17,513.00
| Facility | | $3,641.00 | $10,700.00 | $17,513.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $624.63 / $812.02 / $936.95
| Facility | | $624.63 | $812.02 | $936.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $778.43 / $865.00 / $3,909.74
| Facility | | $778.43 | $865.00 | $3,909.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $5,995.00 / $9,243.00
| Facility | | $1,500.00 | $5,995.00 | $9,243.00 |