- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.04 / $1,161.77 / $6,953.60
| Facility | | $758.04 | $1,161.77 | $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
- $758.04 / $947.25 / $1,388.83
| Facility | | $758.04 | $947.25 | $1,388.83 |
- 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 / $5,794.24 / $7,038.40
| Facility | | $55.00 | $5,794.24 | $7,038.40 |