- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $4,897.79 / $8,511.38
| Facility | | $1,230.27 | $4,897.79 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,786.30 / $10,000.00
| Facility | | $2,238.72 | $4,786.30 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $2,511.89 / $2,511.89
| Facility | | $2,511.89 | $2,511.89 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,380.38 / $3,467.37
| Facility | | $933.25 | $1,380.38 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $257.04 / $478.63 / $478.63
| Facility | AS | $257.04 | $478.63 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $2,818.38 / $10,471.29
| Facility | | $1,202.26 | $2,818.38 | $10,471.29 |