- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $1,790.12 / $6,953.60
| Facility | | $1,615.00 | $1,790.12 | $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
- $1,790.12 / $2,207.98 / $3,291.37
| Facility | | $1,790.12 | $2,207.98 | $3,291.37 |
- 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 / $15,227.73 / $18,430.91
| Facility | | $55.00 | $15,227.73 | $18,430.91 |