- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $1,513.56 / $4,168.69
| Facility | | $398.11 | $1,513.56 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $288.40 / $588.84
| Facility | | $134.90 | $288.40 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $162.18 / $162.18
| Facility | | $39.81 | $162.18 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $645.65 / $812.83
| Facility | | $257.04 | $645.65 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $512.86 / $1,230.27
| Facility | | $190.55 | $512.86 | $1,230.27 |