- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,148.15 / $1,148.15
| Facility | | $1,148.15 | $1,148.15 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $831.76 / $1,548.82
| Facility | | $537.03 | $831.76 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $16.98 / $32.36
| Facility | | $12.02 | $16.98 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $1,513.56 / $3,090.30
| Facility | | $602.56 | $1,513.56 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $630.96 / $630.96
| Facility | | $602.56 | $630.96 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,148.15 / $1,148.15
| Facility | | $1,148.15 | $1,148.15 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $1,230.27 / $1,318.26
| Facility | | $229.09 | $1,230.27 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $1,230.27 / $2,511.89
| Facility | | $398.11 | $1,230.27 | $2,511.89 |