- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $8,912.51 / $45,708.82
| Facility | | $7,079.46 | $8,912.51 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $12,882.50 / $25,118.86
| Facility | | $9,772.37 | $12,882.50 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $2,691.53 / $22,387.21
| Facility | | $1,202.26 | $2,691.53 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $2,089.30 / $2,089.30 / $2,089.30
| Facility | AS | $2,089.30 | $2,089.30 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,691.53 / $2,951.21 / $3,801.89
| Professional | | $2,691.53 | $2,951.21 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $8,511.38 / $14,125.38
| Facility | | $7,079.46 | $8,511.38 | $14,125.38 |