- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $583.48 / $896.00 / $10,152.00
| Facility | | $583.48 | $896.00 | $10,152.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,320.00 / $5,196.00 / $12,571.00
| Facility | | $2,320.00 | $5,196.00 | $12,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $573.65 / $787.36 / $908.28
| Facility | | $573.65 | $787.36 | $908.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $689.98 / $689.98 / $689.98
| Facility | | $689.98 | $689.98 | $689.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $631.00 / $1,850.00 / $8,582.00
| Facility | | $631.00 | $1,850.00 | $8,582.00 |