- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $4,466.84 / $7,244.36
| Facility | | $676.08 | $4,466.84 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,677.35 / $8,912.51
| Facility | | $2,238.72 | $4,677.35 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $2,187.76 / $26,302.68
| Facility | | $562.34 | $2,187.76 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $154.88 / $1,202.26 / $1,202.26
| Facility | AS | $154.88 | $1,202.26 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,090.30 / $5,370.32
| Facility | | $2,137.96 | $3,090.30 | $5,370.32 |