- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,453.73 / $25,453.73 / $25,453.73
| Facility | | $25,453.73 | $25,453.73 | $25,453.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47,000.00 / $81,499.99 / $94,999.99
| Facility | | $47,000.00 | $81,499.99 | $94,999.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,567.41 / $1,567.41 / $1,567.41
| Facility | | $1,567.41 | $1,567.41 | $1,567.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $772.05 / $1,061.57 / $1,567.41
| Facility | | $772.05 | $1,061.57 | $1,567.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,223.59 / $1,223.59 / $14,287.46
| Facility | | $1,223.59 | $1,223.59 | $14,287.46 |