- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $478.63 / $3,467.37
| Facility | | $165.96 | $478.63 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $4,265.80 / $8,317.64
| Facility | | $2,187.76 | $4,265.80 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $165.96 / $186.21
| Facility | | $131.83 | $165.96 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $218.78 / $234.42
| Facility | | $141.25 | $218.78 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $2,137.96 / $5,754.40
| Facility | | $194.98 | $2,137.96 | $5,754.40 |