- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $6,519.00 / $8,994.85
| Facility | | $1,615.00 | $6,519.00 | $8,994.85 |
- 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
- $777.28 / $1,036.41 / $1,263.22
| Facility | | $777.28 | $1,036.41 | $1,263.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $773.00 / $1,208.00 / $9,324.00
| Facility | | $773.00 | $1,208.00 | $9,324.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $4,339.50 / $5,356.44
| Facility | | $55.00 | $4,339.50 | $5,356.44 |