- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $3,890.45 / $9,549.93
| Facility | | $269.15 | $3,890.45 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $13,803.84 / $32,359.37
| Facility | | $1,698.24 | $13,803.84 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $977.24 / $2,290.87
| Facility | | $691.83 | $977.24 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $46.77 / $46.77 / $46.77
| Facility | AS | $46.77 | $46.77 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $933.25 / $1,819.70
| Facility | | $741.31 | $933.25 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $602.56 / $8,317.64
| Facility | | $288.40 | $602.56 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $5,011.87 / $10,715.19
| Facility | | $2,818.38 | $5,011.87 | $10,715.19 |