- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $3,388.44 / $10,715.19
| Facility | | $660.69 | $3,388.44 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $117.49 / $323.59
| Facility | | $34.67 | $117.49 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $11.75 / $11.75 / $11.75
| Facility | AS | $11.75 | $11.75 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $2,630.27 / $6,309.57
| Facility | | $1,348.96 | $2,630.27 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $1,778.28 / $4,168.69
| Facility | | $346.74 | $1,778.28 | $4,168.69 |