- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $5,623.41 / $14,791.08
| Facility | | $1,445.44 | $5,623.41 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $12,302.69 / $30,902.95
| Facility | | $4,466.84 | $12,302.69 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $2,187.76 / $8,709.64
| Facility | | $457.09 | $2,187.76 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $218.78 / $218.78 / $218.78
| Facility | AS | $218.78 | $218.78 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $7,244.36 / $16,982.44
| Facility | | $2,089.30 | $7,244.36 | $16,982.44 |