- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $508.37 / $965.72 / $9,311.00
| Facility | | $508.37 | $965.72 | $9,311.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,088.00 / $3,967.00 / $8,800.00
| Facility | | $2,088.00 | $3,967.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.96 / $688.97 / $794.77
| Facility | | $501.96 | $688.97 | $794.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $604.55 / $604.55 / $604.55
| Facility | | $604.55 | $604.55 | $604.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.00 / $945.00 / $6,295.00
| Facility | | $575.00 | $945.00 | $6,295.00 |