- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.78 / $787.00 / $3,740.00
| Facility | | $530.78 | $787.00 | $3,740.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,212.00 / $9,015.00 / $11,253.00
| Facility | | $7,212.00 | $9,015.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $647.96 / $961.10 / $1,201.38
| Facility | | $647.96 | $961.10 | $1,201.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $847.01 / $847.01 / $847.01
| Facility | | $847.01 | $847.01 | $847.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $973.00 / $4,639.00 / $12,296.00
| Facility | | $973.00 | $4,639.00 | $12,296.00 |