- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,288.25 / $3,890.45
| Facility | | $501.19 | $1,288.25 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $1,348.96 / $3,548.13
| Facility | | $0.02 | $1,348.96 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $104.71 / $104.71
| Facility | | $39.81 | $104.71 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $645.65 / $724.44
| Facility | | $204.17 | $645.65 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,288.25 / $3,630.78
| Facility | | $467.74 | $1,288.25 | $3,630.78 |