- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $4,677.35 / $8,511.38
| Facility | | $1,288.25 | $4,677.35 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $11,481.54 / $19,054.61
| Facility | | $7,413.10 | $11,481.54 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $891.25 / $891.25
| Facility | | $891.25 | $891.25 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,905.46 / $7,943.28
| Facility | | $1,122.02 | $1,905.46 | $7,943.28 |
- 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
- $1,621.81 / $5,754.40 / $10,715.19
| Facility | | $1,621.81 | $5,754.40 | $10,715.19 |