- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $4,466.84 / $8,511.38
| Facility | | $1,698.24 | $4,466.84 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,677.35 / $8,912.51
| Facility | | $2,238.72 | $4,677.35 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,819.70 / $4,786.30
| Facility | | $794.33 | $1,819.70 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $2,187.76 / $3,981.07 / $3,981.07
| Facility | 54 | $2,187.76 | $3,981.07 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $309.03 / $562.34 / $562.34
| Facility | AS | $309.03 | $562.34 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $3,235.94 / $6,309.57
| Facility | | $707.95 | $3,235.94 | $6,309.57 |