- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $5,248.07 / $10,000.00
| Facility | | $100.00 | $5,248.07 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.00 / $3,162.28 / $5,011.87
| Facility | | $1.00 | $3,162.28 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $363.08 / $870.96
| Facility | | $257.04 | $363.08 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $354.81 / $691.83
| Facility | | $281.84 | $354.81 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $204.17 / $2,398.83
| Facility | | $109.65 | $204.17 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $1,862.09 / $3,467.37
| Facility | | $380.19 | $1,862.09 | $3,467.37 |