- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $3,388.44 / $5,623.41
| Facility | | $1,258.93 | $3,388.44 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,089.30 / $11,748.98
| Facility | | $56.23 | $2,089.30 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,174.90 / $1,174.90 / $1,174.90
| Facility | AS | $1,174.90 | $1,174.90 | $1,174.90 |
- 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
- $575.44 / $2,041.74 / $7,079.46
| Facility | | $575.44 | $2,041.74 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $2,454.71 / $4,677.35
| Facility | | $295.12 | $2,454.71 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,089.30 / $11,748.98
| Facility | | $56.23 | $2,089.30 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,174.90 / $1,174.90 / $1,174.90
| Facility | AS | $1,174.90 | $1,174.90 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $2,754.23 / $4,677.35
| Facility | | $794.33 | $2,754.23 | $4,677.35 |