- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,823.15 / $2,924.30 / $21,285.00
| Facility | | $1,823.15 | $2,924.30 | $21,285.00 |
- 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
- $1,899.43 / $2,296.65 / $3,497.65
| Facility | | $1,899.43 | $2,296.65 | $3,497.65 |
- 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 / $21,616.80 / $26,125.32
| Facility | | $55.00 | $21,616.80 | $26,125.32 |