- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $3,235.94 / $5,754.40
| Facility | | $446.68 | $3,235.94 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.02 / $0.03
| Facility | | $0.02 | $0.02 | $0.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $213.80 / $213.80
| Facility | | $39.81 | $213.80 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $524.81 / $812.83
| Facility | | $407.38 | $524.81 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $3,162.28 / $10,964.78
| Facility | | $1,148.15 | $3,162.28 | $10,964.78 |