- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $470.89 / $1,941.00 / $7,212.00
| Facility | | $470.89 | $1,941.00 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,234.00 / $5,126.00 / $8,240.00
| Facility | | $2,234.00 | $5,126.00 | $8,240.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.40 / $612.35 / $926.24
| Facility | | $457.40 | $612.35 | $926.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.00 / $562.96 / $1,627.38
| Facility | | $450.00 | $562.96 | $1,627.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,076.00 / $5,995.00 / $10,413.00
| Facility | | $1,076.00 | $5,995.00 | $10,413.00 |