- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $691.83 / $7,943.28
| Facility | | $537.03 | $691.83 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $851.14 / $851.14
| Facility | | $851.14 | $851.14 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $512.86 / $645.65
| Professional | | $389.05 | $512.86 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $436.52 / $691.83
| Facility | | $275.42 | $436.52 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $524.81 / $562.34
| Facility | | $467.74 | $524.81 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $436.52 / $660.69
| Facility | | $281.84 | $436.52 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,479.11 / $1,479.11
| Facility | | $1,479.11 | $1,479.11 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $4,073.80 / $6,165.95
| Facility | | $389.05 | $4,073.80 | $6,165.95 |