- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $3,890.45 / $8,511.38
| Facility | | $1,288.25 | $3,890.45 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $26,915.35 / $44,668.36
| Facility | | $17,378.01 | $26,915.35 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $15,488.17 / $15,488.17
| Facility | | $15,488.17 | $15,488.17 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $3,235.94 / $20,417.38
| Facility | | $724.44 | $3,235.94 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $177.83 / $5,128.61 / $5,128.61
| Facility | AS | $177.83 | $5,128.61 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $12,302.69 / $20,892.96
| Facility | | $3,467.37 | $12,302.69 | $20,892.96 |