- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $1,895.23 / $6,953.60
| Facility | | $1,615.00 | $1,895.23 | $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
- $1,729.00 / $2,203.84 / $3,441.53
| Facility | | $1,729.00 | $2,203.84 | $3,441.53 |
- 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 / $14,338.00 / $17,366.88
| Facility | | $55.00 | $14,338.00 | $17,366.88 |