- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $514.62 / $1,199.80 / $9,062.00
| Facility | | $514.62 | $1,199.80 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.22 / $1,357.39 / $3,234.31
| Facility | | $512.22 | $1,357.39 | $3,234.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $440.00 / $834.39
| Facility | | $375.00 | $440.00 | $834.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $264.70 / $558.00 / $771.94
| Facility | | $264.70 | $558.00 | $771.94 |
- 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 |