- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $534.29 / $1,924.00 / $9,311.00
| Facility | | $534.29 | $1,924.00 | $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
- $525.79 / $721.69 / $832.52
| Facility | | $525.79 | $721.69 | $832.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $633.12 / $633.12 / $633.12
| Facility | | $633.12 | $633.12 | $633.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $631.00 / $1,121.00 / $8,582.00
| Facility | | $631.00 | $1,121.00 | $8,582.00 |