- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $6,025.60 / $19,054.61
| Facility | | $2,398.83 | $6,025.60 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $5,754.40 / $8,511.38
| Facility | | $1,778.28 | $5,754.40 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,584.89 / $17,378.01
| Facility | | $1,096.48 | $1,584.89 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $288.40 / $288.40 / $4,897.79
| Facility | AS | $288.40 | $288.40 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $12,022.64 / $18,620.87
| Facility | | $4,677.35 | $12,022.64 | $18,620.87 |