- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $707.95 / $11,220.18
| Facility | | $489.78 | $707.95 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $11,220.18 / $28,183.83
| Facility | | $3,467.37 | $11,220.18 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $2,570.40 / $6,165.95
| Facility | | $1,819.70 | $2,570.40 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $81.28 / $81.28 / $81.28
| Facility | AS | $81.28 | $81.28 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $2,454.71 / $4,786.30
| Facility | | $1,995.26 | $2,454.71 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $1,071.52 / $5,623.41
| Facility | | $537.03 | $1,071.52 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $6,309.57 / $13,182.57
| Facility | | $1,584.89 | $6,309.57 | $13,182.57 |