- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,137.96 / $18,197.01
| Facility | | $954.99 | $2,137.96 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $3,801.89 / $9,772.37
| Facility | | $2,290.87 | $3,801.89 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $912.01 / $1,174.90
| Facility | | $645.65 | $912.01 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,230.27 / $1,862.09
| Facility | | $933.25 | $1,230.27 | $1,862.09 |
- 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
- $977.24 / $5,011.87 / $12,302.69
| Facility | | $977.24 | $5,011.87 | $12,302.69 |