- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.58 / $414.92 / $414.92
| Facility | | $25.58 | $414.92 | $414.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $518.22 / $1,308.01 / $2,413.06
| Facility | | $518.22 | $1,308.01 | $2,413.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $932.65 / $1,325.70 / $2,021.34
| Facility | | $932.65 | $1,325.70 | $2,021.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $753.85 / $1,255.14 / $1,591.61
| Facility | | $753.85 | $1,255.14 | $1,591.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.49 / $343.23 / $741.38
| Facility | | $26.49 | $343.23 | $741.38 |