- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $2,691.53 / $8,317.64
| Facility | | $831.76 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,511.38 / $77,624.71
| Facility | | $5,011.87 | $8,511.38 | $77,624.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $407.38 / $407.38
| Facility | | $407.38 | $407.38 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $40.74 / $40.74 / $40.74
| Facility | AS | $40.74 | $40.74 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,344.23 / $8,317.64
| Facility | | $660.69 | $2,344.23 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $478.63 / $478.63
| Facility | | $478.63 | $478.63 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $275.42 / $275.42
| Facility | | $239.88 | $275.42 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $1,071.52 / $4,265.80
| Facility | | $162.18 | $1,071.52 | $4,265.80 |