- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $484.97 / $4,182.08 / $12,765.09
| Facility | | $484.97 | $4,182.08 | $12,765.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,712.35 / $6,198.03 / $11,988.99
| Facility | | $4,712.35 | $6,198.03 | $11,988.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,368.73 / $2,368.73 / $2,368.73
| Facility | | $2,368.73 | $2,368.73 | $2,368.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.56 / $624.59 / $1,682.60
| Facility | | $393.56 | $624.59 | $1,682.60 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $165.01 / $165.01 / $165.01
| Facility | AS | $165.01 | $165.01 | $165.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $793.31 / $1,152.83 / $2,842.49
| Facility | | $793.31 | $1,152.83 | $2,842.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |