- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $4,677.35 / $8,511.38
| Facility | | $2,089.30 | $4,677.35 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $2,754.23 / $3,801.89
| Facility | | $776.25 | $2,754.23 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,479.11 / $10,715.19
| Facility | | $676.08 | $1,479.11 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $158.49 / $158.49 / $1,621.81
| Facility | AS | $158.49 | $158.49 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $7,079.46 / $10,964.78
| Facility | | $4,570.88 | $7,079.46 | $10,964.78 |