- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,194.78 / $1,615.00 / $6,953.60
| Facility | | $1,194.78 | $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
- $1,124.00 / $1,428.07 / $2,143.71
| Facility | | $1,124.00 | $1,428.07 | $2,143.71 |
- 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 / $9,053.52 / $10,961.28
| Facility | | $55.00 | $9,053.52 | $10,961.28 |