- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $2,232.69 / $6,953.60
| Facility | | $1,615.00 | $2,232.69 | $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
- $2,117.56 / $2,621.00 / $4,111.81
| Facility | | $2,117.56 | $2,621.00 | $4,111.81 |
- 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 / $16,917.84 / $20,424.32
| Facility | | $55.00 | $16,917.84 | $20,424.32 |