- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $503.46 / $637.00 / $8,229.00
| Facility | | $503.46 | $637.00 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,643.00 / $3,498.00 / $8,517.00
| Facility | | $1,643.00 | $3,498.00 | $8,517.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $503.63 / $689.82 / $795.76
| Facility | | $503.63 | $689.82 | $795.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $517.86 / $605.74 / $605.74
| Facility | | $517.86 | $605.74 | $605.74 |
- 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 |