- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $6,025.60 / $8,128.31
| Facility | | $512.86 | $6,025.60 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $616.60
| Facility | | $512.86 | $512.86 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $831.76 / $2,290.87
| Facility | | $831.76 | $831.76 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $83.18 / $83.18 / $83.18
| Facility | AS | $83.18 | $83.18 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $3,890.45 / $20,417.38
| Facility | | $2,511.89 | $3,890.45 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $2,454.71 / $9,120.11
| Facility | | $2,454.71 | $2,454.71 | $9,120.11 |