- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $7,079.46 / $25,118.86
| Facility | | $1,071.52 | $7,079.46 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $4,570.88 / $4,786.30
| Facility | | $489.78 | $4,570.88 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $123.03 / $123.03 / $123.03
| Facility | AS | $123.03 | $123.03 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $12,022.64 / $22,908.68
| Facility | | $6,165.95 | $12,022.64 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $12,302.69 / $18,620.87
| Facility | | $4,365.16 | $12,302.69 | $18,620.87 |