- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $353.76 / $5,463.36 / $13,841.56
| Facility | | $353.76 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $528.12 / $765.63 / $1,343.62
| Facility | | $528.12 | $765.63 | $1,343.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.69 / $266.63 / $569.21
| Facility | | $153.69 | $266.63 | $569.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $340.61 / $522.87 / $790.60
| Facility | | $340.61 | $522.87 | $790.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |