- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $354.81 / $5,011.87
| Facility | | $354.81 | $354.81 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $23,988.33 / $61,659.50
| Facility | | $12,882.50 | $23,988.33 | $61,659.50 |
- 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
- $489.78 / $870.96 / $21,379.62
| Facility | | $489.78 | $870.96 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $11,220.18 / $22,908.68
| Facility | | $1,584.89 | $11,220.18 | $22,908.68 |