- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,071.52 / $6,760.83
| Facility | | $1,071.52 | $1,071.52 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $24,547.09 / $58,884.37
| Facility | | $6,456.54 | $24,547.09 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $3,890.45 / $9,332.54
| Facility | | $2,754.23 | $3,890.45 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $186.21 / $186.21 / $186.21
| Facility | AS | $186.21 | $186.21 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $3,715.35 / $7,244.36
| Facility | | $3,019.95 | $3,715.35 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $2,187.76 / $12,022.64
| Facility | | $1,122.02 | $2,187.76 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $9,332.54 / $13,182.57
| Facility | | $4,570.88 | $9,332.54 | $13,182.57 |