- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $3,388.44 / $5,623.41
| Facility | | $676.08 | $3,388.44 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,238.72 / $6,309.57
| Facility | | $56.23 | $2,238.72 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $630.96 / $630.96 / $630.96
| Facility | AS | $630.96 | $630.96 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $676.08 / $741.31
| Facility | | $50.12 | $676.08 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $1,412.54 / $7,079.46
| Facility | | $380.19 | $1,412.54 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $3,801.89 / $9,772.37
| Facility | | $524.81 | $3,801.89 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,238.72 / $6,309.57
| Facility | | $56.23 | $2,238.72 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $630.96 / $630.96 / $630.96
| Facility | AS | $630.96 | $630.96 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $3,801.89 / $8,709.64
| Facility | | $1,071.52 | $3,801.89 | $8,709.64 |