- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $773.04 / $979.69 / $10,152.00
| Facility | | $773.04 | $979.69 | $10,152.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,320.00 / $4,334.00 / $11,433.00
| Facility | | $2,320.00 | $4,334.00 | $11,433.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $852.98 / $1,170.76 / $1,350.56
| Facility | | $852.98 | $1,170.76 | $1,350.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $989.58 / $1,039.43 / $1,039.43
| Facility | | $989.58 | $1,039.43 | $1,039.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.00 / $5,592.00 / $10,113.00
| Facility | | $842.00 | $5,592.00 | $10,113.00 |