- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $1,548.82 / $6,918.31
| Facility | | $275.42 | $1,548.82 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $776.25 / $870.96
| Facility | | $676.08 | $776.25 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $645.65 / $1,071.52
| Facility | | $323.59 | $645.65 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $363.08 / $676.08
| Facility | | $165.96 | $363.08 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $1,778.28 / $5,888.44
| Facility | | $398.11 | $1,778.28 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $3,630.78 / $3,630.78
| Facility | | $56.23 | $3,630.78 | $3,630.78 |