- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $1,949.84 / $9,120.11
| Facility | | $512.86 | $1,949.84 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,073.80 / $9,549.93
| Facility | | $2,630.27 | $4,073.80 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $616.60 / $794.33
| Facility | | $446.68 | $616.60 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $831.76 / $2,290.87
| Facility | | $758.58 | $831.76 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $83.18 / $83.18 / $83.18
| Facility | AS | $83.18 | $83.18 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $2,754.23 / $6,309.57
| Facility | | $602.56 | $2,754.23 | $6,309.57 |