- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.20 / $76.16 / $89.60
| Facility | | $67.20 | $76.16 | $89.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $164.75 / $372.85 / $1,072.74
| Facility | | $164.75 | $372.85 | $1,072.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $235.71 / $334.44 / $804.55
| Facility | | $235.71 | $334.44 | $804.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $185.70 / $305.76 / $633.50
| Facility | | $185.70 | $305.76 | $633.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.33 / $181.56 / $264.54
| Facility | | $112.33 | $181.56 | $264.54 |