- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,313.21 / $2,103.52 / $2,239.38
| Facility | | $1,313.21 | $2,103.52 | $2,239.38 |
- 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
- $1,313.21 / $1,575.85 / $2,425.84
| Facility | | $1,313.21 | $1,575.85 | $2,425.84 |
- 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 / $9,942.48 / $12,027.92
| Facility | | $55.00 | $9,942.48 | $12,027.92 |