- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $446.68 / $537.03
| Facility | | $316.23 | $446.68 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $204.17 / $263.03
| Facility | | $204.17 | $204.17 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $77.62 / $162.18
| Facility | | $54.95 | $77.62 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,023.29 / $1,023.29
| Facility | | $1,023.29 | $1,023.29 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $489.78 / $707.95
| Facility | | $363.08 | $489.78 | $707.95 |