- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $6,760.83 / $12,302.69
| Facility | | $2,238.72 | $6,760.83 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $707.95 / $741.31
| Facility | | $416.87 | $707.95 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $2,951.21 / $3,235.94
| Facility | | $2,951.21 | $2,951.21 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $436.52 / $912.01
| Facility | | $354.81 | $436.52 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $95.50 / $1,548.82 / $1,548.82
| Facility | AS | $95.50 | $1,548.82 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $7,585.78 / $18,197.01
| Facility | | $1,995.26 | $7,585.78 | $18,197.01 |