- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $861.04 / $1,328.42 / $6,953.60
| Facility | | $861.04 | $1,328.42 | $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
- $851.00 / $1,033.25 / $1,578.70
| Facility | | $851.00 | $1,033.25 | $1,578.70 |
- 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 / $6,565.36 / $7,976.72
| Facility | | $55.00 | $6,565.36 | $7,976.72 |