- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $990.98 / $1,518.12 / $6,953.60
| Facility | | $990.98 | $1,518.12 | $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
- $943.81 / $1,189.18 / $1,793.39
| Facility | | $943.81 | $1,189.18 | $1,793.39 |
- 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 / $7,501.84 / $9,094.08
| Facility | | $55.00 | $7,501.84 | $9,094.08 |