- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,128.70 / $4,778.89 / $13,841.56
| Facility | | $1,128.70 | $4,778.89 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,810.78 / $9,230.36 / $17,327.75
| Facility | | $6,810.78 | $9,230.36 | $17,327.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $888.31 / $1,425.73 / $9,480.17
| Facility | | $888.31 | $1,425.73 | $9,480.17 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $2,454.02 / $2,454.02 / $2,454.02
| Facility | AS | $2,454.02 | $2,454.02 | $2,454.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,638.85 / $2,188.02 / $8,672.65
| Facility | | $1,638.85 | $2,188.02 | $8,672.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |