- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $5,128.61 / $13,182.57
| Facility | | $1,288.25 | $5,128.61 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $10,471.29 / $23,442.29
| Facility | | $3,548.13 | $10,471.29 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $2,290.87 / $8,912.51
| Facility | | $1,071.52 | $2,290.87 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $158.49 / $158.49 / $158.49
| Facility | AS | $158.49 | $158.49 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $9,120.11 / $20,892.96
| Facility | | $3,019.95 | $9,120.11 | $20,892.96 |