- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $1,647.01 / $6,953.60
| Facility | | $1,615.00 | $1,647.01 | $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
- $1,647.01 / $2,041.48 / $2,928.13
| Facility | | $1,647.01 | $2,041.48 | $2,928.13 |
- 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 / $12,451.76 / $15,024.32
| Facility | | $55.00 | $12,451.76 | $15,024.32 |