- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $1,288.25 / $3,890.45
| Facility | | $354.81 | $1,288.25 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,258.93 / $2,344.23
| Facility | | $707.95 | $1,258.93 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $93.33 / $602.56
| Facility | | $39.81 | $93.33 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $537.03 / $933.25
| Facility | | $177.83 | $537.03 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,348.96 / $3,388.44
| Facility | | $467.74 | $1,348.96 | $3,388.44 |