- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $4,677.35 / $12,022.64
| Facility | | $1,412.54 | $4,677.35 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $11,748.98 / $24,547.09
| Facility | | $4,168.69 | $11,748.98 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $4,786.30 / $13,803.84
| Facility | | $1,288.25 | $4,786.30 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $263.03 / $263.03 / $263.03
| Facility | AS | $263.03 | $263.03 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $3,235.94 / $13,182.57
| Facility | | $851.14 | $3,235.94 | $13,182.57 |