- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $865.35 / $1,327.49 / $6,953.60
| Facility | | $865.35 | $1,327.49 | $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
- $865.35 / $1,055.06 / $1,584.91
| Facility | | $865.35 | $1,055.06 | $1,584.91 |
- 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 / $5,732.93 / $6,932.03
| Facility | | $55.00 | $5,732.93 | $6,932.03 |