- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,150.44 / $6,029.70 / $10,853.64
| Facility | | $1,150.44 | $6,029.70 | $10,853.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $6,025.59
| Facility | | $606.10 | $606.10 | $6,025.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,150.44 / $1,420.43 / $2,281.98
| Facility | | $1,150.44 | $1,420.43 | $2,281.98 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $176.12 / $198.86 / $364.00
| Facility | AS | $176.12 | $198.86 | $364.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $9,541.00 / $14,589.00
| Facility | | $2,248.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $17,381.18 / $19,913.50
| Facility | | $55.00 | $17,381.18 | $19,913.50 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $269.95 / $1,134.79 / $1,887.52
| Facility | AS | $269.95 | $1,134.79 | $1,887.52 |