- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $593.96 / $1,194.00 / $13,304.00
| Facility | | $593.96 | $1,194.00 | $13,304.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,104.00 / $5,280.00 / $12,101.00
| Facility | | $3,104.00 | $5,280.00 | $12,101.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.94 / $901.40 / $1,039.83
| Facility | | $660.94 | $901.40 | $1,039.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $783.67 / $800.07 / $800.07
| Facility | | $783.67 | $800.07 | $800.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.00 / $4,539.00 / $10,113.00
| Facility | | $842.00 | $4,539.00 | $10,113.00 |