- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $516.57 / $572.54 / $4,846.00
| Facility | | $516.57 | $572.54 | $4,846.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,389.00 / $10,288.00 / $26,304.00
| Facility | | $1,389.00 | $10,288.00 | $26,304.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $477.12 / $620.26 / $715.68
| Facility | | $477.12 | $620.26 | $715.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $596.29 / $761.00 / $3,909.74
| Facility | | $596.29 | $761.00 | $3,909.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,529.00 / $9,550.00 / $15,750.00
| Facility | | $2,529.00 | $9,550.00 | $15,750.00 |