- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,652.00 / $4,067.55 / $7,602.00
| Facility | | $2,652.00 | $4,067.55 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $2,302.00 / $4,232.00
| Facility | | $1,031.00 | $2,302.00 | $4,232.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $525.00 / $2,530.00
| Facility | | $500.00 | $525.00 | $2,530.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $47,197.36 / $48,271.44
| Facility | | $55.00 | $47,197.36 | $48,271.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $875.00 / $2,397.00 / $4,544.00
| Facility | | $875.00 | $2,397.00 | $4,544.00 |