- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $458.16 / $787.00 / $8,229.00
| Facility | | $458.16 | $787.00 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.00 / $2,067.00 / $2,978.00
| Facility | | $1,041.00 | $2,067.00 | $2,978.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $439.12 / $602.71 / $695.27
| Facility | | $439.12 | $602.71 | $695.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $518.38 / $530.65 / $530.65
| Facility | | $518.38 | $530.65 | $530.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $2,723.00 / $6,295.00
| Facility | | $599.00 | $2,723.00 | $6,295.00 |