- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.02 / $437.49 / $600.82
| Facility | | $77.02 | $437.49 | $600.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.44 / $90.08 / $98.16
| Facility | | $81.44 | $90.08 | $98.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.58 / $130.58 / $130.58
| Facility | | $130.58 | $130.58 | $130.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,391.29 / $5,391.29 / $5,391.29
| Facility | | $5,391.29 | $5,391.29 | $5,391.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,305.76 / $3,305.76 / $3,305.76
| Facility | | $3,305.76 | $3,305.76 | $3,305.76 |