- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $5,754.40 / $10,715.19
| Facility | | $1,230.27 | $5,754.40 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $457.09 / $2,951.21
| Facility | | $323.59 | $457.09 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $158.49 / $158.49 / $158.49
| Facility | AS | $158.49 | $158.49 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $20,417.38 / $33,113.11
| Facility | | $8,128.31 | $20,417.38 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $7,585.78 / $12,022.64
| Facility | | $2,290.87 | $7,585.78 | $12,022.64 |