- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $5,495.41 / $10,715.19
| Facility | | $2,041.74 | $5,495.41 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $10,471.29 / $19,498.45
| Facility | | $2,344.23 | $10,471.29 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $17,378.01 / $20,417.38
| Facility | | $7,943.28 | $17,378.01 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $2,290.87 / $10,471.29
| Facility | | $1,148.15 | $2,290.87 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $389.05 / $741.31 / $741.31
| Facility | AS | $389.05 | $741.31 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $4,466.84 / $22,387.21
| Facility | | $3,162.28 | $4,466.84 | $22,387.21 |