- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $5,370.32 / $14,454.40
| Facility | | $1,479.11 | $5,370.32 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $7,413.10 / $15,135.61
| Facility | | $2,818.38 | $7,413.10 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $3,630.78 / $10,232.93
| Facility | | $323.59 | $3,630.78 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $251.19 / $251.19 / $251.19
| Facility | AS | $251.19 | $251.19 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $8,709.64 / $20,892.96
| Facility | | $2,511.89 | $8,709.64 | $20,892.96 |