- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $2,026.88 / $6,953.60
| Facility | | $1,615.00 | $2,026.88 | $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
- $1,933.31 / $2,432.26 / $3,792.04
| Facility | | $1,933.31 | $2,432.26 | $3,792.04 |
- 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 / $15,231.44 / $18,570.56
| Facility | | $55.00 | $15,231.44 | $18,570.56 |