- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.55 / $35.48 / $47.86
| Facility | | $24.55 | $35.48 | $47.86 |
- 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
- $891.25 / $891.25 / $891.25
| Facility | | $891.25 | $891.25 | $891.25 |
- 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
- $316.23 / $2,089.30 / $2,238.72
| Facility | | $316.23 | $2,089.30 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $891.25 / $891.25
| Facility | | $891.25 | $891.25 | $891.25 |