- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $190.55 / $467.74
| Facility | | $123.03 | $190.55 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $794.33 / $1,819.70
| Facility | | $380.19 | $794.33 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $724.44 / $1,737.80
| Facility | | $501.19 | $724.44 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $691.83 / $1,348.96
| Facility | | $562.34 | $691.83 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $257.04 / $588.84
| Facility | | $151.36 | $257.04 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,862.09 / $3,715.35
| Facility | | $1,023.29 | $1,862.09 | $3,715.35 |