- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,479.11 / $4,365.16
| Facility | | $501.19 | $1,479.11 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $380.19 / $851.14
| Facility | | $134.90 | $380.19 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $50.12 / $91.20
| Facility | | $39.81 | $50.12 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $194.98 / $194.98
| Facility | | $194.98 | $194.98 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $524.81 / $1,230.27
| Facility | | $208.93 | $524.81 | $1,230.27 |