- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $823.65 / $8,477.27 / $20,928.72
| Facility | | $823.65 | $8,477.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,619.76 / $8,706.79 / $16,841.75
| Facility | | $6,619.76 | $8,706.79 | $16,841.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $823.65 / $1,441.39 / $4,406.00
| Facility | | $823.65 | $1,441.39 | $4,406.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $233.45 / $439.31 / $439.31
| Facility | AS | $233.45 | $439.31 | $439.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,042.71 / $2,049.23 / $2,754.23
| Facility | | $1,042.71 | $2,049.23 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,054.00 / $4,317.00 / $13,909.00
| Facility | | $3,054.00 | $4,317.00 | $13,909.00 |