- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $489.78 / $7,943.28
| Facility | | $257.04 | $489.78 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $288.40 / $501.19
| Professional | | $208.93 | $288.40 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $257.04 / $446.68
| Facility | | $144.54 | $257.04 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $354.81 / $398.11
| Facility | | $245.47 | $354.81 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $239.88 / $407.38
| Facility | | $151.36 | $239.88 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,258.93 / $1,548.82
| Facility | | $891.25 | $1,258.93 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $1,995.26 / $6,165.95
| Facility | | $389.05 | $1,995.26 | $6,165.95 |