- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $2,934.38 / $6,953.60
| Facility | | $1,615.00 | $2,934.38 | $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
- $2,319.00 / $3,521.26 / $5,385.49
| Facility | | $2,319.00 | $3,521.26 | $5,385.49 |
- 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 / $29,923.96 / $37,038.65
| Facility | | $55.00 | $29,923.96 | $37,038.65 |