- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $766.41 / $943.27 / $10,152.00
| Facility | | $766.41 | $943.27 | $10,152.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,320.00 / $4,334.00 / $11,433.00
| Facility | | $2,320.00 | $4,334.00 | $11,433.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $738.66 / $1,013.85 / $1,169.55
| Facility | | $738.66 | $1,013.85 | $1,169.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $785.80 / $882.64 / $882.64
| Facility | | $785.80 | $882.64 | $882.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $739.00 / $3,828.00 / $8,582.00
| Facility | | $739.00 | $3,828.00 | $8,582.00 |