- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.13 / $89.13 / $2,238.72
| Facility | | $89.13 | $89.13 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $1,412.54 / $3,235.94
| Facility | | $812.83 | $1,412.54 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $331.13 / $794.33
| Facility | | $234.42 | $331.13 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $323.59 / $630.96
| Facility | | $257.04 | $323.59 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $194.98 / $2,951.21
| Facility | | $125.89 | $194.98 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,238.72 / $4,265.80
| Facility | | $1,000.00 | $2,238.72 | $4,265.80 |