- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $524.81 / $1,698.24
| Facility | | $524.81 | $524.81 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $691.83
| Facility | | $575.44 | $575.44 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $912.01 / $912.01
| Facility | | $34.67 | $912.01 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $91.20 / $91.20 / $91.20
| Facility | AS | $91.20 | $91.20 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $10,232.93 / $10,715.19
| Facility | | $7,244.36 | $10,232.93 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $2,454.71 / $8,128.31
| Facility | | $2,454.71 | $2,454.71 | $8,128.31 |