- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $1,288.25 / $3,890.45
| Facility | | $177.83 | $1,288.25 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $389.05 / $549.54
| Facility | | $234.42 | $389.05 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $39.81 / $97.72
| Facility | | $39.81 | $39.81 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.13 / $89.13 / $89.13
| Facility | | $89.13 | $89.13 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $501.19 / $1,202.26
| Facility | | $190.55 | $501.19 | $1,202.26 |