- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $23,483.17
| Facility | | $4,241.22 | $10,431.19 | $23,483.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,463.60 / $34,806.86 / $67,327.71
| Facility | | $26,463.60 | $34,806.86 | $67,327.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,196.74 / $2,094.30 / $9,696.00
| Facility | | $1,196.74 | $2,094.30 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $336.38 / $628.54 / $628.54
| Facility | AS | $336.38 | $628.54 | $628.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.80 / $2,633.75 / $3,930.40
| Facility | | $1,548.80 | $2,633.75 | $3,930.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $15,622.00
| Facility | | $8,148.00 | $9,696.00 | $15,622.00 |