- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $937.02 / $1,496.98 / $6,953.60
| Facility | | $937.02 | $1,496.98 | $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
- $869.00 / $1,125.67 / $1,763.33
| Facility | | $869.00 | $1,125.67 | $1,763.33 |
- 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 / $6,156.29 / $7,652.12
| Facility | | $55.00 | $6,156.29 | $7,652.12 |