- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.15 / $5,463.36 / $19,479.59
| Facility | | $1,506.15 | $5,463.36 | $19,479.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,766.83 / $15,476.59 / $29,936.73
| Facility | | $11,766.83 | $15,476.59 | $29,936.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $646.88 / $1,196.73 / $9,496.00
| Facility | | $646.88 | $1,196.73 | $9,496.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $180.10 / $343.79 / $343.79
| Facility | AS | $180.10 | $343.79 | $343.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $858.24 / $1,652.83 / $2,326.56
| Facility | | $858.24 | $1,652.83 | $2,326.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |