- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,778.28 / $8,511.38
| Facility | | $630.96 | $1,778.28 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $10,715.19 / $11,220.18
| Facility | | $4,466.84 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $933.25 / $1,230.27
| Facility | | $660.69 | $933.25 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,288.25 / $1,288.25
| Facility | | $34.67 | $1,288.25 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $128.82 / $128.82 / $128.82
| Facility | AS | $128.82 | $128.82 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $5,011.87 / $19,054.61
| Facility | | $977.24 | $5,011.87 | $19,054.61 |