- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $689.43 / $971.21 / $2,747.00
| Facility | | $689.43 | $971.21 | $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
- $772.98 / $1,110.52 / $1,281.08
| Facility | | $772.98 | $1,110.52 | $1,281.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $972.50 / $972.50 / $1,200.31
| Facility | | $972.50 | $972.50 | $1,200.31 |
- 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 |