- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $4,466.84 / $21,877.62
| Facility | | $2,187.76 | $4,466.84 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,238.72 / $3,162.28
| Facility | | $630.96 | $2,238.72 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $13,803.84 / $13,803.84
| Facility | | $13,803.84 | $13,803.84 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $1,621.81 / $134,896.29
| Facility | | $363.08 | $1,621.81 | $134,896.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $21,877.62 / $144,543.98
| Facility | | $6,918.31 | $21,877.62 | $144,543.98 |