- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $421.60 / $637.00 / $8,229.00
| Facility | | $421.60 | $637.00 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,643.00 / $3,428.00 / $8,517.00
| Facility | | $1,643.00 | $3,428.00 | $8,517.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.57 / $536.58 / $613.23
| Facility | | $382.57 | $536.58 | $613.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $451.15 / $476.09 / $1,322.53
| Facility | | $451.15 | $476.09 | $1,322.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.00 / $1,450.00 / $5,301.00
| Facility | | $523.00 | $1,450.00 | $5,301.00 |