- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $724.44 / $1,202.26
| Facility | | $323.59 | $724.44 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $338.84 / $676.08
| Facility | | $288.40 | $338.84 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,199.52 / $30,199.52 / $30,199.52
| Facility | | $30,199.52 | $30,199.52 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $1,412.54 / $1,412.54
| Facility | | $1,412.54 | $1,412.54 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $1,174.90 / $38,018.94
| Facility | | $398.11 | $1,174.90 | $38,018.94 |