- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $4,677.35 / $8,317.64
| Facility | | $2,089.30 | $4,677.35 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $2,344.23 / $4,265.80
| Facility | | $891.25 | $2,344.23 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,905.46 / $3,090.30
| Facility | | $724.44 | $1,905.46 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $691.83 / $4,897.79
| Facility | | $537.03 | $691.83 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $144.54 / $912.01 / $912.01
| Facility | AS | $144.54 | $912.01 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $3,890.45 / $7,244.36
| Facility | | $2,818.38 | $3,890.45 | $7,244.36 |