- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $731.22 / $2,321.05 / $8,783.04
| Facility | | $731.22 | $2,321.05 | $8,783.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $603.00 / $1,454.22 / $3,790.27
| Facility | | $603.00 | $1,454.22 | $3,790.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $585.00 / $1,139.16
| Facility | | $375.00 | $585.00 | $1,139.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $290.98 / $538.00 / $627.80
| Facility | | $290.98 | $538.00 | $627.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $586.00 / $6,172.00 / $8,667.00
| Facility | | $586.00 | $6,172.00 | $8,667.00 |