- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $2,321.69 / $6,953.60
| Facility | | $1,615.00 | $2,321.69 | $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
- $1,936.00 / $2,669.96 / $4,268.39
| Facility | | $1,936.00 | $2,669.96 | $4,268.39 |
- 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 / $17,315.91 / $21,425.92
| Facility | | $55.00 | $17,315.91 | $21,425.92 |