- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.65 / $1,156.47 / $9,311.00
| Facility | | $687.65 | $1,156.47 | $9,311.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,755.00 / $8,584.00 / $11,253.00
| Facility | | $4,755.00 | $8,584.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $658.44 / $902.82 / $1,041.47
| Facility | | $658.44 | $902.82 | $1,041.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $791.47 / $791.47 / $973.76
| Facility | | $791.47 | $791.47 | $973.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.00 / $4,539.00 / $10,069.00
| Facility | | $842.00 | $4,539.00 | $10,069.00 |