- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $522.45 / $8,477.27 / $20,928.72
| Facility | | $522.45 | $8,477.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,921.80 / $10,419.34 / $20,154.36
| Facility | | $7,921.80 | $10,419.34 | $20,154.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $522.45 / $966.53 / $3,403.40
| Facility | | $522.45 | $966.53 | $3,403.40 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $145.43 / $268.70 / $268.70
| Facility | AS | $145.43 | $268.70 | $268.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $693.86 / $1,306.10 / $1,834.33
| Facility | | $693.86 | $1,306.10 | $1,834.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |