- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,586.46 / $1,615.00 / $6,953.60
| Facility | | $1,586.46 | $1,615.00 | $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
- $1,288.00 / $1,833.77 / $2,854.31
| Facility | | $1,288.00 | $1,833.77 | $2,854.31 |
- 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 / $11,994.24 / $14,521.52
| Facility | | $55.00 | $11,994.24 | $14,521.52 |