- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $544.94 / $730.33 / $2,747.00
| Facility | | $544.94 | $730.33 | $2,747.00 |
- 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
- $625.90 / $929.52 / $1,072.27
| Facility | | $625.90 | $929.52 | $1,072.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $818.36 / $818.36 / $822.08
| Facility | | $818.36 | $818.36 | $822.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.00 / $4,539.00 / $10,113.00
| Facility | | $842.00 | $4,539.00 | $10,113.00 |