- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $407.38 / $7,585.78
| Facility | | $251.19 | $407.38 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $380.19 / $630.96
| Facility | | $251.19 | $380.19 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $33,113.11 / $58,884.37
| Facility | | $14,125.38 | $33,113.11 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,584.89 / $1,584.89
| Facility | | $56.23 | $1,584.89 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $158.49 / $158.49 / $158.49
| Facility | AS | $158.49 | $158.49 | $158.49 |