- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $3,890.45 / $7,762.47
| Facility | | $2,089.30 | $3,890.45 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,019.95
| Facility | | $630.96 | $2,041.74 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $741.31 / $6,309.57
| Facility | | $512.86 | $741.31 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $138.04 / $138.04 / $851.14
| Facility | AS | $138.04 | $138.04 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $4,073.80 / $7,244.36
| Facility | | $2,754.23 | $4,073.80 | $7,244.36 |