- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,214.11 / $1,757.94 / $6,953.60
| Facility | | $1,214.11 | $1,757.94 | $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
- $1,214.11 / $1,721.06 / $2,192.37
| Facility | | $1,214.11 | $1,721.06 | $2,192.37 |
- 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 / $14,819.09 / $17,866.55
| Facility | | $55.00 | $14,819.09 | $17,866.55 |