- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $346.74 / $5,011.87
| Facility | | $346.74 | $346.74 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $27,542.29 / $77,624.71
| Facility | | $16,595.87 | $27,542.29 | $77,624.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $1,174.90 / $2,754.23
| Facility | | $831.76 | $1,174.90 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,122.02 / $2,187.76
| Facility | | $891.25 | $1,122.02 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $851.14 / $25,118.86
| Facility | | $549.54 | $851.14 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $13,182.57 / $26,915.35
| Facility | | $5,370.32 | $13,182.57 | $26,915.35 |