- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $992.26 / $1,603.15 / $4,389.32
| Facility | | $992.26 | $1,603.15 | $4,389.32 |
- 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
- $802.00 / $1,176.43 / $1,806.76
| Facility | | $802.00 | $1,176.43 | $1,806.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $773.00 / $1,208.00 / $9,324.00
| Facility | | $773.00 | $1,208.00 | $9,324.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $7,414.48 / $13,960.05
| Facility | | $55.00 | $7,414.48 | $13,960.05 |