- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,692.25 / $1,753.67 / $2,227.17
| Facility | | $1,692.25 | $1,753.67 | $2,227.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.03 / $0.03
| Facility | | $0.02 | $0.03 | $0.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.00 / $40.00 / $1,077.90
| Facility | | $40.00 | $40.00 | $1,077.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.00 / $26,937.00 / $28,908.00
| Facility | | $400.00 | $26,937.00 | $28,908.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.00 / $6,034.00 / $13,506.00
| Facility | | $1,200.00 | $6,034.00 | $13,506.00 |