- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $3,630.78 / $5,623.41
| Facility | | $1,949.84 | $3,630.78 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $3,019.95 / $8,128.31
| Facility | | $56.23 | $3,019.95 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $724.44 / $724.44 / $724.44
| Facility | AS | $724.44 | $724.44 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $741.31 / $831.76
| Facility | | $50.12 | $741.31 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $1,819.70 / $7,079.46
| Facility | | $575.44 | $1,819.70 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $4,570.88 / $11,220.18
| Facility | | $645.65 | $4,570.88 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $3,019.95 / $8,128.31
| Facility | | $56.23 | $3,019.95 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $724.44 / $724.44 / $724.44
| Facility | AS | $724.44 | $724.44 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $5,011.87 / $12,022.64
| Facility | | $1,479.11 | $5,011.87 | $12,022.64 |