- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $468.34 / $546.72 / $3,740.00
| Facility | | $468.34 | $546.72 | $3,740.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,010.00 / $2,045.00 / $2,978.00
| Facility | | $1,010.00 | $2,045.00 | $2,978.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.03 / $596.05 / $681.22
| Facility | | $425.03 | $596.05 | $681.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $474.38 / $531.27 / $1,322.53
| Facility | | $474.38 | $531.27 | $1,322.53 |
- 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 |