- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $2,152.19 / $6,953.60
| Facility | | $1,615.00 | $2,152.19 | $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
- $1,953.00 / $2,582.64 / $3,976.85
| Facility | | $1,953.00 | $2,582.64 | $3,976.85 |
- 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 / $16,045.52 / $19,870.96
| Facility | | $55.00 | $16,045.52 | $19,870.96 |