- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $3,890.45 / $8,511.38
| Facility | | $1,288.25 | $3,890.45 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $13,803.84 / $22,908.68
| Facility | | $8,912.51 | $13,803.84 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $5,754.40 / $5,754.40
| Facility | | $5,754.40 | $5,754.40 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $371.54 / $7,413.10
| Facility | | $169.82 | $371.54 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $56.23 / $104.71 / $104.71
| Facility | AS | $56.23 | $104.71 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $724.44 / $2,511.89
| Facility | | $138.04 | $724.44 | $2,511.89 |