- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.65 / $8,477.27 / $20,928.72
| Facility | | $375.65 | $8,477.27 | $20,928.72 |
- 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
- $5,266.26 / $5,266.26 / $5,266.26
| Facility | | $5,266.26 | $5,266.26 | $5,266.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $447.66 / $713.74 / $1,930.88
| Facility | | $447.66 | $713.74 | $1,930.88 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $188.17 / $188.17 / $188.17
| Facility | AS | $188.17 | $188.17 | $188.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $904.66 / $1,325.32 / $6,319.51
| Facility | | $904.66 | $1,325.32 | $6,319.51 |
- 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 |