- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.70 / $4,466.84 / $11,220.18
| Facility | | $25.70 | $4,466.84 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $6,760.83 / $13,803.84
| Facility | | $2,818.38 | $6,760.83 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.12 / $41.69 / $125.89
| Facility | | $25.12 | $41.69 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $2.69 / $2.69 / $2.69
| Facility | AS | $2.69 | $2.69 | $2.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $1,202.26 / $3,715.35
| Facility | | $295.12 | $1,202.26 | $3,715.35 |