- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $709.65 / $709.76 / $24,319.52
| Facility | | $709.65 | $709.76 | $24,319.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,339.87 / $12,197.67 / $25,424.06
| Facility | | $3,339.87 | $12,197.67 | $25,424.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,722.38 / $2,443.81 / $5,878.93
| Facility | | $1,722.38 | $2,443.81 | $5,878.93 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $80.34 / $80.34 / $80.34
| Facility | AS | $80.34 | $80.34 | $80.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,565.80 / $2,234.23 / $4,629.08
| Facility | | $1,565.80 | $2,234.23 | $4,629.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $731.96 / $1,435.75 / $8,097.52
| Facility | | $731.96 | $1,435.75 | $8,097.52 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $182.62 / $182.62 / $182.62
| Facility | AS | $182.62 | $182.62 | $182.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,457.00 / $9,370.00 / $12,774.00
| Facility | | $5,457.00 | $9,370.00 | $12,774.00 |