- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $5,463.36 / $13,841.56
| Facility | | $1,653.00 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,952.65 / $9,144.62 / $17,688.66
| Facility | | $6,952.65 | $9,144.62 | $17,688.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $838.53 / $1,467.43 / $5,452.45
| Facility | | $838.53 | $1,467.43 | $5,452.45 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $239.99 / $433.26 / $433.26
| Facility | AS | $239.99 | $433.26 | $433.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,059.30 / $2,082.96 / $2,764.49
| Facility | | $1,059.30 | $2,082.96 | $2,764.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |