- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $2,344.23 / $4,897.79
| Facility | | $251.19 | $2,344.23 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $14,125.38 / $19,054.61
| Facility | | $6,456.54 | $14,125.38 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $234.42 / $263.03
| Facility | | $223.87 | $234.42 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $380.19 / $602.56
| Facility | | $245.47 | $380.19 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $323.59 / $323.59 / $323.59
| Facility | 52 | $323.59 | $323.59 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $40.74 / $40.74 / $40.74
| Facility | AS | $40.74 | $40.74 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $5,623.41 / $12,022.64
| Facility | | $1,023.29 | $5,623.41 | $12,022.64 |