- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.17 / $5,589.24 / $5,589.24
| Facility | | $1,031.17 | $5,589.24 | $5,589.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.99 / $100.68 / $109.69
| Facility | | $90.99 | $100.68 | $109.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $145.88 / $145.88 / $145.88
| Facility | | $145.88 | $145.88 | $145.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,537.92 / $8,537.92 / $8,537.92
| Facility | | $8,537.92 | $8,537.92 | $8,537.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,318.53 / $5,318.53 / $5,318.53
| Facility | | $5,318.53 | $5,318.53 | $5,318.53 |