- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,809.04 / $6,149.92 / $18,744.04
| Facility | | $1,809.04 | $6,149.92 | $18,744.04 |
- 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
- $1,809.04 / $2,313.59 / $3,257.70
| Facility | | $1,809.04 | $2,313.59 | $3,257.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,717.00 / $2,500.00 / $18,665.00
| Facility | | $1,717.00 | $2,500.00 | $18,665.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,800.00 / $20,718.24 / $24,992.88
| Facility | | $2,800.00 | $20,718.24 | $24,992.88 |