- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $485.13 / $896.00 / $10,152.00
| Facility | | $485.13 | $896.00 | $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
- $484.26 / $663.26 / $765.13
| Facility | | $484.26 | $663.26 | $765.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $473.74 / $582.65 / $582.65
| Facility | | $473.74 | $582.65 | $582.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $739.00 / $3,853.00 / $8,582.00
| Facility | | $739.00 | $3,853.00 | $8,582.00 |