- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $2,343.27 / $6,953.60
| Facility | | $1,615.00 | $2,343.27 | $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
- $2,018.00 / $2,816.00 / $4,344.93
| Facility | | $2,018.00 | $2,816.00 | $4,344.93 |
- 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 / $17,483.84 / $21,641.60
| Facility | | $55.00 | $17,483.84 | $21,641.60 |