- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $549.54 / $7,943.28
| Facility | | $275.42 | $549.54 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $2,290.87 / $2,398.83
| Facility | | $2,290.87 | $2,290.87 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $363.08 / $588.84
| Professional | | $245.47 | $363.08 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $263.03 / $489.78
| Facility | | $147.91 | $263.03 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $426.58 / $489.78
| Facility | | $295.12 | $426.58 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $269.15 / $478.63
| Facility | | $144.54 | $269.15 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $10,232.93 / $12,022.64
| Facility | | $7,413.10 | $10,232.93 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $9,549.93 / $12,882.50
| Facility | | $1,621.81 | $9,549.93 | $12,882.50 |