- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.19 / $922.56 / $10,152.00
| Facility | | $794.19 | $922.56 | $10,152.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,565.00 / $6,410.00 / $15,330.00
| Facility | | $3,565.00 | $6,410.00 | $15,330.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $858.75 / $1,174.17 / $1,354.49
| Facility | | $858.75 | $1,174.17 | $1,354.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,036.81 / $1,036.81 / $1,036.81
| Facility | | $1,036.81 | $1,036.81 | $1,036.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $973.00 / $6,818.00 / $12,296.00
| Facility | | $973.00 | $6,818.00 | $12,296.00 |