- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $452.43 / $1,123.00 / $11,093.00
| Facility | | $452.43 | $1,123.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.00 / $5,948.00 / $9,462.00
| Facility | | $2,754.00 | $5,948.00 | $9,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $437.52 / $585.74 / $1,050.05
| Facility | | $437.52 | $585.74 | $1,050.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $356.73 / $646.00 / $1,375.01
| Facility | | $356.73 | $646.00 | $1,375.01 |
- 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 |