- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $4,897.79 / $19,498.45
| Facility | | $660.69 | $4,897.79 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $8,317.64 / $10,471.29
| Facility | | $2,344.23 | $8,317.64 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $616.60 / $691.83
| Facility | | $588.84 | $616.60 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $1,047.13 / $1,862.09
| Facility | | $758.58 | $1,047.13 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $104.71 / $104.71 / $104.71
| Facility | AS | $104.71 | $104.71 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $6,025.60 / $10,715.19
| Facility | | $2,137.96 | $6,025.60 | $10,715.19 |