- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $1,318.26 / $8,511.38
| Facility | | $851.14 | $1,318.26 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $9,549.93 / $11,220.18
| Facility | | $5,128.61 | $9,549.93 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,148.15 / $1,621.81
| Facility | | $933.25 | $1,148.15 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,819.70 / $1,819.70
| Facility | | $34.67 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $181.97 / $181.97 / $181.97
| Facility | AS | $181.97 | $181.97 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $4,168.69 / $30,199.52
| Facility | | $407.38 | $4,168.69 | $30,199.52 |