- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,559.39 / $8,477.27 / $21,899.37
| Facility | | $1,559.39 | $8,477.27 | $21,899.37 |
- 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
- $891.08 / $1,559.39 / $7,993.09
| Facility | | $891.08 | $1,559.39 | $7,993.09 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $247.35 / $445.06 / $445.06
| Facility | AS | $247.35 | $445.06 | $445.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,060.41 / $2,107.28 / $3,015.95
| Facility | | $1,060.41 | $2,107.28 | $3,015.95 |
- 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 |