- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,046.70 / $4,077.02 / $9,122.93
| Facility | | $1,046.70 | $4,077.02 | $9,122.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,062.80
| Facility | | $606.10 | $606.10 | $2,062.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $679.47 / $881.40 / $1,289.81
| Facility | | $679.47 | $881.40 | $1,289.81 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $123.18 / $123.40 / $224.50
| Facility | AS | $123.18 | $123.40 | $224.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $5,950.27 / $6,817.20
| Facility | | $55.00 | $5,950.27 | $6,817.20 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $156.72 / $388.48 / $646.16
| Facility | AS | $156.72 | $388.48 | $646.16 |