- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $1,778.28 / $8,128.31
| Facility | | $316.23 | $1,778.28 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $11,220.18 / $26,302.68
| Facility | | $2,041.74 | $11,220.18 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $1,202.26 / $2,884.03
| Facility | | $758.58 | $1,202.26 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $58.88 / $58.88 / $58.88
| Facility | AS | $58.88 | $58.88 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,174.90 / $2,290.87
| Facility | | $933.25 | $1,174.90 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $660.69 / $6,760.83
| Facility | | $331.13 | $660.69 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $6,309.57 / $12,589.25
| Facility | | $2,951.21 | $6,309.57 | $12,589.25 |