- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $578.96 / $781.41 / $2,747.00
| Facility | | $578.96 | $781.41 | $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
- $654.65 / $943.46 / $1,088.35
| Facility | | $654.65 | $943.46 | $1,088.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $825.07 / $825.07 / $965.73
| Facility | | $825.07 | $825.07 | $965.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $2,723.00 / $6,295.00
| Facility | | $599.00 | $2,723.00 | $6,295.00 |