- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.48 / $630.96 / $3,090.30
| Facility | | $52.48 | $630.96 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $14,125.38 / $33,884.42
| Facility | | $3,019.95 | $14,125.38 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $2,511.89 / $5,888.44
| Facility | | $1,778.28 | $2,511.89 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $117.49 / $117.49 / $117.49
| Facility | AS | $117.49 | $117.49 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $2,398.83 / $4,677.35
| Facility | | $1,905.46 | $2,398.83 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $1,380.38 / $10,964.78
| Facility | | $645.65 | $1,380.38 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $9,120.11 / $18,620.87
| Facility | | $4,466.84 | $9,120.11 | $18,620.87 |