- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,422.47 / $2,265.26 / $10,924.00
| Facility | | $1,422.47 | $2,265.26 | $10,924.00 |
- 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
- $1,422.47 / $1,722.00 / $2,617.82
| Facility | | $1,422.47 | $1,722.00 | $2,617.82 |
- 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 / $10,774.16 / $13,035.36
| Facility | | $55.00 | $10,774.16 | $13,035.36 |