- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $847.89 / $2,318.00 / $11,093.00
| Facility | | $847.89 | $2,318.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,473.00 / $7,200.00 / $15,727.00
| Facility | | $3,473.00 | $7,200.00 | $15,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $810.21 / $1,084.67 / $1,640.67
| Facility | | $810.21 | $1,084.67 | $1,640.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.00 / $646.00 / $2,806.76
| Facility | | $450.00 | $646.00 | $2,806.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,399.00 / $5,995.00 / $10,413.00
| Facility | | $1,399.00 | $5,995.00 | $10,413.00 |