- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $1,288.25 / $3,715.35
| Facility | | $338.84 | $1,288.25 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.50 / $478.63 / $1,096.48
| Facility | | $95.50 | $478.63 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.90 / $30.90 / $39.81
| Facility | | $30.90 | $30.90 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.18 / $69.18 / $69.18
| Facility | | $69.18 | $69.18 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $512.86 / $1,258.93
| Facility | | $194.98 | $512.86 | $1,258.93 |