- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $738.79 / $1,139.02 / $6,953.60
| Facility | | $738.79 | $1,139.02 | $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
- $738.79 / $891.24 / $1,363.47
| Facility | | $738.79 | $891.24 | $1,363.47 |
- 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 / $5,590.48 / $6,790.88
| Facility | | $55.00 | $5,590.48 | $6,790.88 |