- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $4,786.30 / $8,317.64
| Facility | | $275.42 | $4,786.30 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $616.60 / $933.25
| Facility | | $436.52 | $616.60 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $446.68 / $446.68
| Facility | | $446.68 | $446.68 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $257.04 / $3,019.95
| Facility | | $109.65 | $257.04 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,288.25 / $3,311.31
| Facility | | $1,023.29 | $1,288.25 | $3,311.31 |