- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.50 / $95.50 / $2,630.27
| Facility | | $95.50 | $95.50 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $3,311.31 / $6,760.83
| Facility | | $1,479.11 | $3,311.31 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $363.08 / $870.96
| Facility | | $229.09 | $363.08 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $346.74 / $676.08
| Facility | | $281.84 | $346.74 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.33 / $169.82 / $2,238.72
| Facility | | $102.33 | $169.82 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $2,691.53 / $6,456.54
| Facility | | $1,230.27 | $2,691.53 | $6,456.54 |