- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $7,079.46 / $12,882.50
| Facility | | $1,548.82 | $7,079.46 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $35,481.34 / $83,176.38
| Facility | | $5,370.32 | $35,481.34 | $83,176.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $5,623.41 / $13,182.57
| Facility | | $3,981.07 | $5,623.41 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $275.42 / $275.42 / $275.42
| Facility | AS | $275.42 | $275.42 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $5,370.32 / $10,471.29
| Facility | | $4,265.80 | $5,370.32 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,388.44 / $11,481.54
| Facility | | $1,698.24 | $3,388.44 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $6,309.57 / $13,182.57
| Facility | | $1,584.89 | $6,309.57 | $13,182.57 |