- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $5,370.32 / $9,549.93
| Facility | | $537.03 | $5,370.32 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $5,370.32 / $10,471.29
| Facility | | $2,238.72 | $5,370.32 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $10,715.19 / $22,908.68
| Facility | | $3,090.30 | $10,715.19 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $537.03 / $10,964.78
| Facility | | $323.59 | $537.03 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $87.10 / $1,548.82 / $1,548.82
| Facility | AS | $87.10 | $1,548.82 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $3,981.07 / $8,912.51
| Facility | | $2,454.71 | $3,981.07 | $8,912.51 |