- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $4,897.79 / $8,511.38
| Facility | | $1,698.24 | $4,897.79 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $7,079.46 / $13,803.84
| Facility | | $2,238.72 | $7,079.46 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $1,548.82 / $9,772.37
| Facility | | $831.76 | $1,548.82 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $275.42 / $512.86 / $512.86
| Facility | AS | $275.42 | $512.86 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $2,818.38 / $11,220.18
| Facility | | $1,288.25 | $2,818.38 | $11,220.18 |