- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $4,168.69 / $17,782.79
| Facility | | $724.44 | $4,168.69 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $794.33 / $954.99
| Facility | | $794.33 | $794.33 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,258.93 / $2,290.87
| Facility | | $1,258.93 | $1,258.93 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $125.89 / $125.89 / $125.89
| Facility | AS | $125.89 | $125.89 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $2,454.71 / $6,606.93
| Facility | | $2,454.71 | $2,454.71 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $3,548.13 / $20,417.38
| Facility | | $3,548.13 | $3,548.13 | $20,417.38 |