- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $965.96 / $1,615.00 / $11,124.00
| Facility | | $965.96 | $1,615.00 | $11,124.00 |
- 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
- $930.22 / $1,166.00 / $1,785.94
| Facility | | $930.22 | $1,166.00 | $1,785.94 |
- 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 / $7,325.60 / $8,877.60
| Facility | | $55.00 | $7,325.60 | $8,877.60 |