- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,234.07 / $1,739.84 / $6,953.60
| Facility | | $1,234.07 | $1,739.84 | $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
- $1,234.07 / $1,703.34 / $2,214.76
| Facility | | $1,234.07 | $1,703.34 | $2,214.76 |
- 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 / $9,370.71 / $11,318.32
| Facility | | $55.00 | $9,370.71 | $11,318.32 |