- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.36 / $2,098.56 / $6,953.60
| Facility | | $1,286.36 | $2,098.56 | $6,953.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.71 / $518.28 / $35,600.00
| Facility | | $0.71 | $518.28 | $35,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,008.00 / $1,535.40 / $2,366.34
| Facility | | $1,008.00 | $1,535.40 | $2,366.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.00 / $661.00 / $4,877.00
| Facility | | $301.00 | $661.00 | $4,877.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $7,191.96 / $8,923.92
| Facility | | $55.00 | $7,191.96 | $8,923.92 |