- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.53 / $1,615.00 / $6,953.60
| Facility | | $1,346.53 | $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
- $1,278.55 / $1,615.84 / $2,448.61
| Facility | | $1,278.55 | $1,615.84 | $2,448.61 |
- 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 / $17,726.24 / $21,495.74
| Facility | | $55.00 | $17,726.24 | $21,495.74 |