- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $16,218.10 / $26,302.68
| Facility | | $11,748.98 | $16,218.10 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $3,715.35 / $6,025.60
| Facility | | $3,162.28 | $3,715.35 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $4,365.16 / $7,413.10
| Facility | | $1,348.96 | $4,365.16 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $2,691.53 / $14,125.38
| Facility | | $1,258.93 | $2,691.53 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $7,762.47 / $7,762.47
| Facility | | $3,162.28 | $7,762.47 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $316.23 / $316.23 / $776.25
| Facility | AS | $316.23 | $316.23 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $14,125.38 / $15,488.17
| Facility | | $13,489.63 | $14,125.38 | $15,488.17 |