- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $4,677.35 / $8,317.64
| Facility | | $2,187.76 | $4,677.35 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $2,570.40 / $3,801.89
| Facility | | $776.25 | $2,570.40 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $1,122.02 / $9,332.54
| Facility | | $758.58 | $1,122.02 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $208.93 / $208.93 / $1,905.46
| Facility | AS | $208.93 | $208.93 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $7,079.46 / $10,964.78
| Facility | | $5,495.41 | $7,079.46 | $10,964.78 |