- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $616.60 / $1,047.13
| Facility | | $407.38 | $616.60 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $16,595.87 / $32,359.37
| Facility | | $5,128.61 | $16,595.87 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,290.87 / $5,370.32
| Facility | | $1,584.89 | $2,290.87 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $69.18 / $69.18 / $69.18
| Facility | AS | $69.18 | $69.18 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $2,187.76 / $4,265.80
| Facility | | $1,737.80 | $2,187.76 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $831.76 / $3,311.31
| Facility | | $489.78 | $831.76 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $4,786.30 / $9,332.54
| Facility | | $2,398.83 | $4,786.30 | $9,332.54 |