- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,634.35 / $3,978.97 / $7,602.00
| Facility | | $2,634.35 | $3,978.97 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $945.00 / $2,218.00 / $4,232.00
| Facility | | $945.00 | $2,218.00 | $4,232.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $525.00 / $2,530.00
| Facility | | $500.00 | $525.00 | $2,530.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $52,757.92 / $54,164.80
| Facility | | $55.00 | $52,757.92 | $54,164.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $875.00 / $2,397.00 / $4,544.00
| Facility | | $875.00 | $2,397.00 | $4,544.00 |