- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.81 / $8,477.27 / $20,928.72
| Facility | | $691.81 | $8,477.27 | $20,928.72 |
- 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
- $691.81 / $1,279.84 / $5,406.60
| Facility | | $691.81 | $1,279.84 | $5,406.60 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $191.46 / $354.84 / $354.84
| Facility | AS | $191.46 | $354.84 | $354.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $923.86 / $1,727.46 / $2,438.14
| Facility | | $923.86 | $1,727.46 | $2,438.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $15,622.00
| Facility | | $8,148.00 | $9,696.00 | $15,622.00 |