- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $2,896.08 / $6,953.60
| Facility | | $1,615.00 | $2,896.08 | $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
- $2,753.31 / $3,252.06 / $5,058.21
| Facility | | $2,753.31 | $3,252.06 | $5,058.21 |
- 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 / $43,719.52 / $52,757.92
| Facility | | $55.00 | $43,719.52 | $52,757.92 |