- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $4,265.80 / $9,332.54
| Facility | | $1,288.25 | $4,265.80 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,786.30 / $8,912.51
| Facility | | $2,238.72 | $4,786.30 | $8,912.51 |
- 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
- $1,047.13 / $1,698.24 / $3,467.37
| Facility | | $1,047.13 | $1,698.24 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $281.84 / $512.86 / $512.86
| Facility | AS | $281.84 | $512.86 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $2,818.38 / $5,370.32
| Facility | | $1,737.80 | $2,818.38 | $5,370.32 |