- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.37 / $3,677.85 / $9,449.34
| Facility | | $776.37 | $3,677.85 | $9,449.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $699.19 / $853.80 / $1,397.74
| Facility | | $699.19 | $853.80 | $1,397.74 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $114.10 / $119.53 / $221.22
| Facility | AS | $114.10 | $119.53 | $221.22 |
- 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 / $7,817.95 / $8,957.00
| Facility | | $55.00 | $7,817.95 | $8,957.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $165.61 / $510.42 / $849.00
| Facility | AS | $165.61 | $510.42 | $849.00 |