- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $5,495.41 / $10,715.19
| Facility | | $2,238.72 | $5,495.41 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $7,943.28 / $14,454.40
| Facility | | $2,238.72 | $7,943.28 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $3,019.95 / $10,232.93
| Facility | | $1,513.56 | $3,019.95 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $524.81 / $977.24 / $977.24
| Facility | AS | $524.81 | $977.24 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $4,466.84 / $19,054.61
| Facility | | $3,162.28 | $4,466.84 | $19,054.61 |