- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,818.38 / $10,471.29
| Facility | | $954.99 | $2,818.38 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $10,715.19 / $11,220.18
| Facility | | $9,332.54 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,513.56 / $1,949.84
| Facility | | $1,047.13 | $1,513.56 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $2,041.74 / $2,041.74
| Facility | | $34.67 | $2,041.74 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $204.17 / $204.17 / $204.17
| Facility | AS | $204.17 | $204.17 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $5,011.87 / $12,302.69
| Facility | | $977.24 | $5,011.87 | $12,302.69 |